Dr. Lukas H Tan, M.D.
Pediatrics, Neonatal-Perinatal Medicine in Jacksonville, FL. Individual provider (NPI-1).
Details
- NPI
- 1104885789
- Entity type
- Individual (NPI-1)
- Name
- Dr. Lukas H Tan
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 21, 2006
- Last updated
- Aug 7, 2019
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PEDIATRIC MEDICINE
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2080N0001X | Pediatrics, Neonatal-Perinatal Medicine | ME54721 | FL | Yes |
| 208000000X | Pediatrics | ME54721 | FL |
Practice location
655 W 8th StUfjp Neonatology
Jacksonville, FL 32209-6511
Phone 904-244-4254 · Fax 904-244-4301
Mailing address
Po Box 44008Ufjp Provider Enrollment
Jacksonville, FL 32231-4008
Phone 904-244-3660 · Fax 904-244-3425
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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