JACK TSAN PH.D.
NPI 1639441850
Psychologist in Austin, TX

Active since February 03, 2012Opted out of Medicare · through Oct 1, 2026
8701 SHOAL CREEK BLVD STE 404, AUSTIN, TX 78757(512) 879-1836 Get Directions Write a Review

NPPES record last updated: September 29, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jack Tsan Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK TSAN PH.D. (NPI 1639441850) is an individual psychologist in Austin, Texas, licensed in Texas (35206) and active in the NPI registry since February 2012. He has opted out of Medicare through October 1, 2026 and maintains a secondary practice location in Waco.

NPPES Registry Identity

NPI1639441850
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameJACK TSANCredential: PH.D.
Location Address8701 SHOAL CREEK BLVD STE 404Austin, TX 78757-6809
Mailing Address4708 Bull Creek RdAustin, TX 78731-5506
Sole ProprietorNo
Enumeration DateFebruary 3, 2012
Last NPPES UpdateSeptember 29, 2018
NPI 1639441850 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in TX · 35206
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Also ListedPsychologist · CounselingTaxonomy 103TC1900X · License 35206 (TX)
8701 SHOAL CREEK BLVD STE 404, Austin, TX 78757

Secondary Practice Location 1

Location 14800 Memorial Dr, 151CWaco, TX 76711-1329 · Phone (254) 297-3000 ext. 55606

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Jack Tsan Ph.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 1, 2022 through October 1, 2026.

Opt-Out Effective DateOctober 1, 2022
Opt-Out In Effect ThroughOctober 1, 2026Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Counselor (Mental Health)
8701 SHOAL CREEK BLVD STE 404
AUSTIN, TX 78757
Psychologist (Counseling)
8701 SHOAL CREEK BLVD STE 404
AUSTIN, TX 78757
Psychologist (Clinical Child & Adolescent)
8701 SHOAL CREEK BLVD STE 404
AUSTIN, TX 78757
Psychologist (Clinical)
8701 SHOAL CREEK BLVD STE 404
AUSTIN, TX 78757
Counselor (Professional)
8701 SHOAL CREEK BLVD STE 404
AUSTIN, TX 78757
Psychologist
8701 SHOAL CREEK BLVD STE 404
AUSTIN, TX 78757
Psychologist (Clinical)
8701 SHOAL CREEK BLVD STE 404
AUSTIN, TX 78757

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Tsan's NPI number?

The NPI number for Jack Tsan is 1639441850. It was assigned to this individual provider in the NPPES registry on February 3, 2012.

Where is Jack Tsan located?

Jack Tsan practices at 8701 Shoal Creek Blvd Ste 404, Austin, TX 78757. The listed phone number is (512) 879-1836.

What is Jack Tsan's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Jack Tsan enrolled in Medicare?

No. Jack Tsan has opted out of Medicare through October 1, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Jack Tsan was last updated on September 29, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.