Individual provider Active NPI

Liana Niculina Tanase, M.D.

  • Psychiatry Physician
  • Ontario, CA
National Provider Identifier
1124070560
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A79427 Issued in CA
Practice address
855 N Euclid Ave Ofc
Ontario, CA 91762-2729
Phone
(909) 983-2020
Fax
(909) 983-6847
NPI assigned
May 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A79427 CA Primary

Addresses

Primary practice location

855 N Euclid Ave Ofc
Ontario, CA 91762-2729

Mailing address

855 N Euclid Ave Ofc
Ontario, CA 91762-2729
Phone (909) 983-2020

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
I20050902000510 CA Practitioner - Psychiatry 3678505245 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West End Family Counseling ServiceGroup PAC ID 6709813280, 2 clinicians

Practice addresses (Care Compare)

855 N Euclid Ave
Ontario, CA 91762-2729
Phone 90998320202231

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
79427CAMDPharmacist
A79427CAMDPsychiatry Physician

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.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1124070560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 N EUCLID AVE OFC",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917622729",
            "telephone_number": "909-983-2020",
            "fax_number": "909-983-6847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 N EUCLID AVE OFC",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917622729",
            "telephone_number": "909-983-2020",
            "fax_number": "909-983-6847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANASE",
        "first_name": "LIANA",
        "middle_name": "NICULINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A79427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, CA

Sources for this page

Verify at the official NPI Registry.