Provider Demographics
NPI:1134108525
Name:TAPEN, ELIZABETH M (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:M
Last Name:TAPEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 161029
Mailing Address - Street 2:
Mailing Address - City:BIG SKY
Mailing Address - State:MT
Mailing Address - Zip Code:59716-1029
Mailing Address - Country:US
Mailing Address - Phone:845-797-8700
Mailing Address - Fax:
Practice Address - Street 1:2091 LITTLE COYOTE RD STE 161029
Practice Address - Street 2:
Practice Address - City:BIG SKY
Practice Address - State:MT
Practice Address - Zip Code:59716-7979
Practice Address - Country:US
Practice Address - Phone:845-797-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY23233812085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2374E2OtherEMPIRE BCBS
NY2622228Medicaid
NY376669OtherMVP
NY82318OtherGHI HMO
NY2390E1OtherEMPIRE BCBS
NY376670OtherMVP
NY82317OtherGHI HMO
NY2374E1OtherEMPIRE BCBS
NY4099497OtherGHI PPO
NY02622228Medicaid
NY3792539OtherAETNA USHC HMO
NY4099496OtherGHI PPO
NY2390E2OtherEMPIRE BCBS
NY5567616OtherAETNA USHC PPO
NY376669OtherMVP
NY2390E1OtherEMPIRE BCBS
NYG63320Medicare UPIN
NYP00235140Medicare ID - Type UnspecifiedRAILROAD MEDICARE