STEPHEN R TAN (NPI# 1669446415) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669446415 |
| Entity Type | Individual |
| Full Name | STEPHEN R TAN |
| Credential | MD |
| Practice Address |
401 Phalen Blvd Saint Paul MN 55130-5302 |
| Practice Telephone | 6512547580 |
| Practice Fax Number | 6512547584 |
| Mailing Telephone | 6512547580 |
| Mailing Fax Number | 6512547584 |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2020-08-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | 44614 | MN | Allopathic & Osteopathic Physicians |
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
44614 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 064221500 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3800 Park Nicollet Blvd, St Louis Park, MN 554162527 | 9529933286 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457901654 | Stephen Jay Tan | Pharmacist | 655 W 8th St, Jacksonville, FL 32209-6511 | 2019-09-19 |
| 1336638519 | Stephen Paul Tan | Student in an Organized Health Care Education/Training Program | 1215 Lee St, Charlottesville, VA 22908-2804 | 2018-05-03 |
| Street Address |
401 PHALEN BLVD |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55130-5302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982699740 | Marlane J Brown | Optometrist | 401 Phalen Blvd, Saint Paul, MN 55130-5302 | 2005-09-16 |
| 1588297113 | Choua Yang Polaski | Nurse Practitioner | 401 Phalen Blvd, Saint Paul, MN 55130-5302 | 2020-02-21 |
| 1588295687 | Fadumo Adan Salad | Nurse Practitioner | 401 Phalen Blvd, Saint Paul, MN 55130-5302 | 2020-01-28 |
| 1992345110 | Hannah Kristine Dahl | Physician Assistant | 401 Phalen Blvd, Saint Paul, MN 55130-5302 | 2020-01-15 |
| 1417476185 | Rebecca Horvath | Audiologist | 401 Phalen Blvd, Saint Paul, MN 55130-5302 | 2017-09-14 |
| 1154867430 | Erika Jarvey | Physician Assistant | 401 Phalen Blvd, Saint Paul, MN 55130-5302 | 2017-01-11 |
| 1134674682 | Kacie Jo Massey | Physician Assistant | 401 Phalen Blvd, Saint Paul, MN 55130-5302 | 2016-08-24 |
| 1902251325 | Jennifer Lonetti | Physical Therapist | 401 Phalen Blvd, Saint Paul, MN 55130-5302 | 2016-05-04 |
| 1003270232 | Andrea Langeveld | Dermatology | 401 Phalen Blvd, Saint Paul, MN 55130-5302 | 2016-04-13 |
| 1649640152 | Brittany Rae Kelly | Physician Assistant | 401 Phalen Blvd, Saint Paul, MN 55130 | 2015-09-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164904587 | Confident Care LLC | In Home Supportive Care | 1040 Arkwright Street, Saint Paul, MN 55130 | 2018-09-01 |
| 1881015253 | Lucas Bosco Wanga | Psychologist | 715 Edgerton Street, Merrick Community Services, St. Paul, MN 55130 | 2014-01-02 |
| 1174865570 | Sarang Patel | Internal Medicine | 401 Phalen Blvd # 41103d, Saint Paul, MN 55130 | 2013-03-23 |
| 1427394501 | Zongxee Lee | Registered Nurse | 1072 Payne Ave, St. Paul, MN 55130 | 2012-12-18 |
| 1740532753 | One Stop Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 1049 Payne Ave Suite C, St Paul, MN 55130 | 2012-10-15 |
| 1689923997 | Alexis Simmons | Counselor | 402 University Ave East, Suite A-127, Saint Paul, MN 55130 | 2012-08-31 |
| 1689804064 | Group Health Plan, Inc. | Durable Medical Equipment & Medical Supplies | 537 Phalen Blvd, Saint Paul, MN 55130 | 2009-07-21 |
| 1477756534 | Chad Everett Christensen | Chiropractor | 1073 Payne Ave, Saint Paul, MN 55130 | 2007-06-07 |
| 1922219021 | Qwik Urgent Care Clinic | Family Medicine | 1239 Payne Avenue, Saint Paul, MN 55130 | 2007-05-24 |
| 1275743981 | Yia Vang | Technician | 1100 Arkwright St., St. Paul, MN 55130 | 2007-05-23 |
| Find all providers in zip 55130 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770115610 | Dermatology Partners Pllc | Dermatology | 4041 28th St Nw Ste 200, Rochester, MN 55901-7943 | 2020-02-09 |
| 1023460243 | Ji Won Ahn | Dermatology | 200 1st St Sw, Rochester, MN 55905-5902 | 2016-07-12 |
| 1487018263 | Sama Kassira Carley | Dermatology | 200 1st St Sw, Rochester, MN 55905-0001 | 2016-04-07 |
| 1740532340 | Clarus Dermatology Pa | Dermatology | 2603 39th Ave Ne, Suite D-202, Minneapolis, MN 55421-4372 | 2012-10-05 |
| 1598925513 | Ian A Maher | Dermatology | 909 Fulton St Se, Minneapolis, MN 55455 | 2008-06-12 |
| 1235323585 | Bart Theodore Endrizzi | Dermatology | 420 Delaware St Se, Minneapolis, MN 55455-0341 | 2007-08-29 |
| 1730206541 | Michael Robert Campoli | Dermatology | 5200 Fairview Blvd, Wyoming, MN 55092-8013 | 2007-03-25 |
| City | SAINT PAUL |
| Zip Code | 55130 |
Please comment or provide details below to improve the information on STEPHEN R TAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.