Djerrick Tan, M.D.
NPI 1124002654 · Diagnostic Radiology Physician · Mequon, WI
Enrolled with Medicare as Practitioner - Diagnostic Radiology · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Djerrick Tan, M.D. is a Diagnostic Radiology Physician provider in Mequon, WI (NPI 1124002654).
Provider details
- NPI number
- 1124002654
- Entity type
- Individual
- Primary specialty
- Diagnostic Radiology PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 1025471 (MA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
20 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
3 documented practice locations
- Medicare service volume (vs. specialty peers)28% of score
2,408 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| X-Ray of Chest, 1 View71045 | 487 | $8 |
| Ct Scan of Chest Without Contrast71250 | 251 | $47 |
| Ct Scan of Abdomen and Pelvis With Contrast74177 | 190 | $80 |
| Ct Scan Head Or Brain Without Contrast70450 | 153 | $37 |
| Ct Scan of Chest With Contrast71260 | 116 | $50 |
| Ct Scan of Abdomen and Pelvis Without Contrast74176 | 110 | $77 |
Practice location
Mailing address
Additional practice locations (2)
- 211 Park StAttleboro, MA 02703-3143Phone: (508) 222-5200
- 450 Veterans Memorial Pkwy Bldg 2East Providence, RI 02914-5300Phone: (401) 435-3041Fax: (401) 435-3042
Registry dates
- Enumerated
- 2005-11-29
- Last updated
- 2026-02-23
- Certified
- 2026-02-23
Frequently asked questions
- What is Djerrick Tan's NPI number?
- Djerrick Tan's National Provider Identifier (NPI) is 1124002654, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Djerrick Tan's specialty?
- Djerrick Tan is listed in the NPPES registry with a primary specialty of Diagnostic Radiology Physician (Allopathic & Osteopathic Physicians).
- Where is Djerrick Tan located?
- Djerrick Tan's practice location on file with NPPES is 10945 N Port Washington Rd Ste 201, Mequon, WI 53092-5078.
- What is Djerrick Tan's phone number?
- The practice phone number listed in the NPPES registry for Djerrick Tan is (262) 292-3151.
- Does Djerrick Tan accept Medicare?
- Djerrick Tan is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Djerrick Tan's NPI active?
- Yes — Djerrick Tan's NPI (1124002654) is active in the NPPES registry as of the last update on 2026-02-23.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.