Angie-Kolleen Sandico Tan, FNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

NP95006893 Issued in CA

Practice address

9606 Cherry Hill St
Pacoima, CA 91331-1514

Phone

(323) 620-7412

NPI assigned

Sep 28, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Karpus Medical Group IncGroup PAC ID 3577604883, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

78.21 of 100Reported as group

Quality

53.33

Improvement activities

40

Cost

56.26

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Healthnet Home Care Services, Inc.

  • Home Health Agency
  • Burbank, CA
  • NPI 1891997466

  W-2 Managing Employee

  CMS ownership

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Karpus Medical Group Inc

  • General Practice Physician
  • Woodland Hills, CA
  • NPI 1902130016
  Medicare reassignment Care Compare group

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1475020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508198400000",
    "number": "1063961324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9606 CHERRY HILL ST",
            "city": "PACOIMA",
            "state": "CA",
            "postal_code": "913311514",
            "telephone_number": "323-620-7412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9606 CHERRY HILL ST",
            "city": "PACOIMA",
            "state": "CA",
            "postal_code": "913311514",
            "telephone_number": "323-620-7412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "ANGIE-KOLLEEN",
        "middle_name": "SANDICO",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-28",
        "last_updated": "2017-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "775609",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "NP95006893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erengo E Suto
• Sanch Gerald Aragones Sy, BSN, MSN, PMHNP-BC
• William Taetzsch
• Parviz P Taheri, M.D.
• Kimberly Marie Tallas
• Sloane Taplin
• Ani Tashdjian, B.A.
• Eddie Renard Taylor
• Helene R Taylor
• Noe Tejeda

• Psychiatric/Mental Health Nurse Practitioner in Pacoima, CA
• Providers in Pacoima, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.