Individual provider Active NPI

Christy Chingli Tan, FNP

  • Family Nurse Practitioner
  • West Covina, CA
National Provider Identifier
1295057545
Registry record updated Feb 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP 19526 Issued in CA
Practice address
420 S Glendora Ave
West Covina, CA 91790-3001
Phone
(626) 919-4333
Fax
(626) 919-5724
NPI assigned
Feb 26, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP 19526 CA Primary

Addresses

Primary practice location

420 S Glendora Ave
West Covina, CA 91790-3001

Mailing address

522 S Petunia St
La Habra, CA 90631-9253
Phone (714) 521-9241

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110311000449 CA Practitioner - Nurse Practitioner 8325220387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of California, Irvine, California College of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Valley Community Health Center, Inc.Group PAC ID 9234041765, 50 clinicians

Practice addresses (Care Compare)

1555 S Garey Ave
Pomona, CA 91766-5222
Phone (626) 919-4333

420 S Glendora Ave
West Covina, CA 91790-3001
Phone 6269194333259

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NP 19526CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
East Valley Community Health Center, Inc. Current Accepting new patients
East Valley Community Health Center, Inc. CurrentSince Sep 7, 2011 Accepting new patients

Locations

1555 S Garey Ave
Pomona, CA 91766
Phone (909) 620-8088

420 S Glendora Ave
West Covina, CA 91790
Phone (626) 919-5724

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: christy.tan.p1@direct.evchc.nextgenshare.com

Organizations & group practices 2

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": "1267142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267142400000",
    "number": "1295057545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "522 S PETUNIA ST",
            "city": "LA HABRA",
            "state": "CA",
            "postal_code": "906319253",
            "telephone_number": "714-521-9241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 S GLENDORA AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903001",
            "telephone_number": "626-919-4333",
            "fax_number": "626-919-5724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "CHRISTY",
        "middle_name": "CHINGLI",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-26",
        "last_updated": "2010-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP 19526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.