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JACKY TAN
NPI 1992190771
Emergency Medicine in Forest Hills, NY

Active since March 30, 2015PECOS EnrolledAccepts Medicare Assignment
91.25/100
CMS Quality Rating
10201 66TH RD, FOREST HILLS, NY 11375(212) 420-2000 Get Directions Write a Review

NPPES record last updated: April 28, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 28, 2022, Mar 4, 2022 (2 updates tracked since 2022).

About Jacky Tan NPPES

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

JACKY TAN (NPI 1992190771) is an individual emergency medicine provider in Forest Hills, New York, licensed in New York (293166-01) and active in the NPI registry since March 2015. He is enrolled in Medicare PECOS, is affiliated with Long Island Jewish Medical Center, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1992190771
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameJACKY TAN
Location Address10201 66TH RDForest Hills, NY 11375-2029
Mailing Address10 Nathan D Perlman PlNew York, NY 10003-3851 · (212) 420-2000
Phone(212) 420-2000
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateMarch 30, 2015
Last NPPES UpdateApril 28, 20222 updates tracked since enumeration
NPPES CertifiedApril 28, 2022
✔ NPI 1992190771 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in NY · 293166-01
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
10201 66TH RD, Forest Hills, NY 11375
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jacky Tan is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2264797646
PECOS Enrollment IDI20180606001452
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
182 services176 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
59 services47 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Long Island Jewish Medical Center

Acute Care Hospitals · New Hyde Park, NY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330195
Location270 - 05 76th AvenueNew Hyde Park, NY 11040 · Nassau County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11375 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$104.17 typical visit price
range $67.00 – $201.98
Typical copayment $26.04 (range $16.75 – $50.49)
Most-billed visit code 99203
Established Patient
$116.96 typical visit price
range $21.62 – $163.52
Typical copayment $29.24 (range $5.40 – $40.88)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

91.25/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality74.92
Promoting Interoperability91.67
Improvement Activities40

Other Providers at the Same Location NPPES 20

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

SRAVYA REDDY MUNDLA
Student in an Organized Health Care Education/Training Program
10201 66TH RD
FOREST HILLS, NY 11375
Queens County (718) 830-4352
MR. SHIVNATHAN PILLAI SA
Specialist
10201 66TH RD
FOREST HILLS, NY 11375
Queens County (718) 830-4000
DR. JOHN DEPETRILLO JR. M.D.
Internal Medicine (Critical Care Medicine)
10201 66TH RD
FOREST HILLS, NY 11375
Queens County (718) 830-4359
XIN YUN LI MD
Surgery (Vascular Surgery)
10201 66TH RD
FOREST HILLS, NY 11375
Queens County (718) 830-4093
FARHAD MOHAMMAD GAZI MD
Emergency Medicine
10201 66TH RD, MEDICAL STAFF OFFICE
FOREST HILLS, NY 11375
Queens County (718) 830-4200
ANDREA ROMMAL
Student in an Organized Health Care Education/Training Program
10201 66TH RD
FOREST HILLS, NY 11375
Queens County (718) 830-4352
MARK WANIS DO
Student in an Organized Health Care Education/Training Program
10201 66TH RD
FOREST HILLS, NY 11375
Queens County (718) 830-4352
DR. PAUL SOLODNIK M.D.
Radiology (Diagnostic Radiology)
10201 66TH RD, RADIOLOGY DEPARTMENT
FOREST HILLS, NY 11375
Queens County (952) 595-1100

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 Jacky Tan's NPI number?

The NPI number for Jacky Tan is 1992190771. It was assigned to this individual provider in the NPPES registry on March 30, 2015.

Where is Jacky Tan located?

Jacky Tan practices at 10201 66th Rd, Forest Hills, NY 11375. The listed phone number is (212) 420-2000.

What is Jacky Tan's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Jacky Tan enrolled in Medicare?

Yes. Jacky Tan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Jacky Tan affiliated with any hospitals?

According to CMS data, Jacky Tan is affiliated with Long Island Jewish Medical Center.

When was this NPI record last updated?

The NPPES record for Jacky Tan was last updated on April 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.