Individual provider Active NPI

Peter Xuepeng Tan, M.D.

  • Internal Medicine Physician
  • Arcadia, CA
National Provider Identifier
1144228909
Registry record updated Mar 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A69134 Issued in CA
Practice address
612 W Duarte Rd Ste 205
Arcadia, CA 91007-9229
Phone
(626) 317-5136
Fax
(888) 378-7367
NPI assigned
Jul 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A69134 CA Primary

Addresses

Primary practice location

612 W Duarte Rd Ste 205
Arcadia, CA 91007-9229

Mailing address

612 W Duarte Rd Ste 205
Arcadia, CA 91007-9229
Phone (626) 317-5136

Other practice location 1

624 W Duarte Rd Ste 208
Arcadia, CA 91007-7675
Phone (626) 446-3608

Other identifiers 1

IdentifierTypeStateIssuer
00A691340MedicaidCA

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
I20040714001318 CA Practitioner - Internal Medicine 9739168782 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peter Yang Ma Medical IncGroup PAC ID 9739240193, 2 clinicians

Practice addresses (Care Compare)

2900 E del Mar Blvd
Pasadena, CA 91107-4375
Phone (626) 354-9113

624 W Duarte Rd
Suite 208
Arcadia, CA 91007-7675
Phone (626) 294-9978

Hospital & facility affiliations

  • Diamond Home Health Services, Inc Home health agency, Diamond Bar, CA, CCN 059499
  • Bright Care Home Health, Inc Home health agency, Rosemead, CA, CCN 058396

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A69134CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peter X. Tan Medical Corporation Internal Medicine CurrentSince Mar 29, 2005 Accepting new patients
Peter Yang Ma Medical Inc CurrentSince Feb 21, 2023 Accepting new patients
Ahmc San Gabriel Valley Medical Past Accepting new patients
Ahmc Garfield Medical Center LP Past Accepting new patients
GN Medical Associates, Inc. PastSince Apr 1, 2007 Accepting new patients

Locations

612 W Duarte Rd
Ste 205
Arcadia, CA 91007
Phone (626) 317-5136

612 W Duarte Rd
Ste 505
Arcadia, CA 91007
Phone (626) 294-9978

624 W Duarte Rd
Ste 208
Arcadia, CA 91007
Phone (626) 294-9978

2900 E Del Mar Blvd
Pasadena, CA 91107
Phone (310) 559-5916

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: peter.tan.p4@direct.regal.nextgenshare.com

Organizations & group practices 5

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": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774137600000",
    "number": "1144228909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 W DUARTE RD STE 205",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910079229",
            "telephone_number": "626-317-5136",
            "fax_number": "888-378-7367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 W DUARTE RD STE 205",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910079229",
            "telephone_number": "626-317-5136",
            "fax_number": "888-378-7367"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "624 W Duarte Rd Ste 208",
            "address_purpose": "LOCATION",
            "city": "Arcadia",
            "state": "CA",
            "postal_code": "910077675",
            "country_code": "US",
            "telephone_number": "626-446-3608",
            "fax_number": "626-446-3817",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAN",
        "first_name": "PETER",
        "middle_name": "XUEPENG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-14",
        "last_updated": "2026-03-22",
        "certification_date": "2026-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A69134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A691340",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arcadia, CA

Sources for this page

Verify at the official NPI Registry.