Individual provider Active NPI

Anna Maria Maglunog Tan, DPM

  • Foot & Ankle Surgery Podiatrist
  • Glendora, CA
National Provider Identifier
1154741858
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E5307 Issued in CA
Practice address
412 W Carroll Ave Ste 107
Glendora, CA 91741-4708
Phone
(626) 963-8351
NPI assigned
Apr 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X E5307 CA Primary

Addresses

Primary practice location

412 W Carroll Ave Ste 107
Glendora, CA 91741-4708

Mailing address

1135 S Sunset Ave Ste 200
West Covina, CA 91790-3937
Phone (626) 918-6655

Other practice location 1

1135 S Sunset Ave Ste 200
West Covina, CA 91790-3937
Phone (626) 918-6655

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171013000329 CA Practitioner - Podiatry 5698040806 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E5307CAMDFoot & Ankle Surgery Podiatrist

Practice roles (7 of 8)

OrganizationSpecialtyStatusNew patients
Emanate Health Medical Group CurrentSince Sep 11, 2017 Accepting new patients
Emanate Health Medical Group Current Accepting new patients
Emanate Health Medical Care Foundation CurrentSince Jan 1, 2024 Accepting new patients
Citrus Valley Physician Partners CurrentSince Sep 11, 2017 Accepting new patients
St. Joseph Health Northern California, LLC Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients
Emanate Health Medical Center Past Accepting new patients

Locations

14375 Pipeline Ave
Chino, CA 91710
Phone (626) 918-6544

210 W San Bernardino Rd
Covina, CA 91723
Phone (626) 858-8580

315 N 3rd Ave
Ste 102
Covina, CA 91723
Phone (626) 261-4048

440 W Foothill Blvd
Glendora, CA 91741
Phone (626) 963-9402

250 S Grand Ave
Glendora, CA 91741
Phone (626) 857-3118

412 W Carroll Ave
Ste 107
Glendora, CA 91741
Phone (626) 852-0411

1135 S Sunset Ave
Ste 200
West Covina, CA 91790
Phone (626) 918-6655

1115 S Sunset Ave
Ste 200
West Covina, CA 91790
Phone (626) 732-8390

1250 S Sunset Ave
Ste 100
West Covina, CA 91790
Phone (626) 338-1800

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 7

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 6

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

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emanate Health Medical Care Foundation 85 clinicians

Practice addresses (Care Compare)

1115 S Sunset Ave
West Covina, CA 91790-3940

412 W Carroll Ave
Suite 108
Glendora, CA 91741-4707
Phone (626) 852-0411

Hospital & facility affiliations

  • Brightlane Healthcare, Inc. Home health agency, Montclair, CA, CCN 559655
  • Sante Home Health, Inc Home health agency, Diamond Bar, CA, CCN 559040
  • Emanate Health Inter-Community Hospital Hospital, Covina, CA, CCN 050382
  • Emanate Health Foothill Presbyterian Hospital Hospital, Glendora, CA, CCN 050597

Merit-based Incentive Payment System (MIPS)

Final score
84.36 of 100Reported as group
Quality
60.04
Promoting interoperability
87
Improvement activities
40
Cost
69.31

Merit-based Incentive Payment System (MIPS)

Final score
82.35 of 100Reported as group
Quality
52.92
Promoting interoperability
93
Improvement activities
40
Cost
70.76

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue242
Removal of nail tissue75
Removal or shaving of skin growth84

NPI Registry JSON

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

{
    "created_epoch": "1398038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1154741858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 S SUNSET AVE STE 200",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903937",
            "telephone_number": "626-918-6655",
            "fax_number": "626-918-8614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 W CARROLL AVE STE 107",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414708",
            "telephone_number": "626-963-8351"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1135 S Sunset Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "West Covina",
            "state": "CA",
            "postal_code": "917903937",
            "country_code": "US",
            "telephone_number": "626-918-6655",
            "fax_number": "626-918-8614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAN",
        "first_name": "ANNA MARIA",
        "middle_name": "MAGLUNOG",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-21",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E5307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

Verify at the official NPI Registry.