ZALDY S TAN (M.D.) – Geriatric Medicine (Internal Medicine) Physician, NPI 1174585376

ZALDY S TAN (M.D.) is a healthcare provider. based in Roxbury crossing, Massachusetts. specializing in INTERNAL MEDICINE, GERIATRIC MEDICINE. They hold the professional credentials M.D.. They hold a License No. 160230 (MA). The NPI Number for ZALDY S TAN (M.D.) is 1174585376

Main info

Male
33 Years Of Experience
Accepts Medicare Assignment
Name
ZALDY S TAN (M.D.)
NPI
1174585376
Phone
(857) 364-5012
Address
1625 Tremont St Fl 3
Enumeration Date
4 April 2006
Last Update Date
24 August 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3104233277
Graduation Year
1993 (33 years ago)
PAC ID
5395927966
Group Practice PAC ID
0446169114
Professional Enrollment ID
I20120322000099
Address ID
CA900481804WE8700XBLVD300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience73
Completeness75
Years active:20State licenses:2Digital endpointsOther names

7,722 INTERNAL MEDICINE in MA

Provider Addresses for ZALDY S TAN (M.D.)

  • 1625 Tremont St Fl 3

    Brigham and Women's Hospital Division of Aging

    Roxbury Crossing, MA 021201616

    Phone: (857) 364-5012

    Type: Location

  • West 190th Street, Harbor Gateway, Torrance, Los Angeles County, California, 90278, United States

    TORRANCE, CA 905045513

    Phone:

    Type: Mailing

  • 127 S SAN VICENTE BLVD # A6600

    LOS ANGELES, CA 900483311

    Phone: (310) 423-6472

    Fax: (310) 423-0148

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2012-03-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20120322000099IGeriatric MedicineCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
G2212Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or4337$0
99205New patient office or other outpatient visit, 60-74 minutes3737$0
99215Established patient office or other outpatient visit, 40-54 minutes3527$0
96116Exam of neurobehavioral status, first hour1414$0
View full utilization report →

Insurance plans in this area (ZIP 02120)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0446169114View full group profile
NameSpecialtyState
Critical Care (Intensivists), General SurgeryCA
-WA
Nurse PractitionerCA
Physician AssistantCA
Clinical PsychologistCA
Nurse PractitionerCA
N E U R O S U R G E R YOH
Nurse PractitionerCA
General Surgery, Critical Care (Intensivists)CA
Internal MedicineCA

Reviews

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Frequently asked questions

Is ZALDY S TAN (M.D.) listed with a National Provider Identifier?
Yes — ZALDY S TAN (M.D.) has NPI 1174585376 on file in the registry.
Is ZALDY S TAN (M.D.) shown as active in public data?
Registry records indicate ZALDY S TAN (M.D.) maintains an active NPI.
What area of care is associated with ZALDY S TAN (M.D.)?
ZALDY S TAN (M.D.)'s record emphasizes Geriatric Medicine (Internal Medicine) Physician. Clinical services aligned with this taxonomy classification.
Is ZALDY S TAN (M.D.) located near Roxbury Crossing?
ZALDY S TAN (M.D.) currently maps to Roxbury Crossing, Massachusetts in this extract.
Can I trust this NPI listing for ZALDY S TAN (M.D.)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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