595 W LAKE MEAD PKWY
HENDERSON, NV 89015-7015 US PECOS Enrolled
Frederick Jones Tanenggee
Internal Medicine Physician
- HENDERSON, NV
- Phone: (702)-565-1007
- Last Updated 10/20/2022
Overview
Frederick Jones Tanenggee is a Internal Medicine Physician in the HENDERSON area and has over 29 years of experience. Frederick Jones Tanenggee primary office location is at 595 W LAKE MEAD PKWY and new patients are welcome to contact this healthcare provider for an appointment. We do not know where he was educated but we know that he graduated in 1995 The NPI number is 1245284959 and the information was updated approximately 2 years ago.
Frederick Jones Tanenggee is affiliated with one medical group in the HENDERSON area, INTERMOUNTAIN MEDICAL HOLDINGS NEVADA INC.
We have not detected any Exclusions tied directly to this NPI.
Accepts Medicare Assignment: Unknown
Is sole proprietor: NO
Participates in PECOS: YES (See any PECOS details below)
Contact Information
| License Number | State |
|---|---|
| 9921 | NV |
| Type/Issuer | Identifier | State |
|---|---|---|
| STATE LICENSE | 9921 | NV |
| MEDICAID | 1245284959 | NV |
| Taxonomy | State | Primary? |
|---|---|---|
| Internal Medicine Physician - Taxonomy Code 207R00000X | NV | Y |
PECOS Details:
| Participates in PECOS: | YES |
| PECOS Individual Enrollment ID: | I20031121000199 |
| PECOS Individual PAC ID: | 1557265527 |
| Eligible to order/refer Part B Clinical Laboratory and Imaging | Yes |
| Eligible to order/refer Durable Medical Equipment (DME) | Yes |
| Eligible to order/refer Home Health Agency (HHA) | Yes |
| Eligible to order/refer Power Mobility Devices (PMD) | Yes |
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