Individual provider Active NPI

Ann Zera Tan, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Los Angeles, CA
National Provider Identifier
1093976938
Registry record updated Jun 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
A95082 Issued in CA
Practice address
1200 N State St
Los Angeles County Medical Center, GH Room 2900
Los Angeles, CA 90033-1029
Phone
(323) 226-7149
NPI assigned
Jun 23, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X A95082 CA Primary

Addresses

Primary practice location

1200 N State St
Los Angeles County Medical Center, GH Room 2900
Los Angeles, CA 90033-1029

Mailing address

2895 Shakespeare Dr
San Marino, CA 91108-2230
Phone (323) 226-7149

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090708000544 CA Practitioner - Pathology 2163574963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glendale Pathology Associates Medical Group of GlendaleGroup PAC ID 2860482221, 8 clinicians

Practice addresses (Care Compare)

1509 Wilson Ter
Glendale, CA 91206-4007
Phone (818) 409-8320

1509 Wilson Terrace
Glendale, CA 91206-4007

1720 Cesar E Chaves Ave
Los Angeles, CA 90033-2414
Phone (323) 268-5000

20350 Ventura Blvd
Suite 205
Woodland Hills, CA 91364-2488
Phone (818) 718-9510

2975 Sycamore Dr
Simi Valley, CA 93065-1201
Phone (805) 955-6000

Hospital & facility affiliations

  • Adventist Health White Memorial Hospital, Los Angeles, CA, CCN 050103
  • Glendale Adventist Medical Center Hospital, Glendale, CA, CCN 050239

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
97.98
Improvement activities
40
Cost
82.67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A95082CAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Glendale Pathology Associates Medical Group of Glendale Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2009 Accepting new patients

Locations

1509 Wilson Ter
Glendale, CA 91206
Phone (818) 409-8071

1720 E Cesar E Chavez Ave
Los Angeles, CA 90033
Phone (323) 260-5781

2975 Sycamore Dr
Simi Valley, CA 93065
Phone (805) 522-2500

5700 Southwyck Blvd
Toledo, OH 43614

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214179200000",
    "number": "1093976938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2895 SHAKESPEARE DR",
            "city": "SAN MARINO",
            "state": "CA",
            "postal_code": "911082230",
            "telephone_number": "323-226-7149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N STATE ST",
            "address_2": "LOS ANGELES COUNTY MEDICAL CENTER, GH ROOM 2900",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900331029",
            "telephone_number": "323-226-7149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "ANN",
        "middle_name": "ZERA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-23",
        "last_updated": "2008-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "A95082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.