Organization Active NPI

Tan and Tan Medical Group Prof LLC

  • Family Medicine Physician
  • Las Vegas, NV
National Provider Identifier
1346198975
Registry record updated Mar 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
TAN AND TAN MEDICAL GROUP PROF LLC
Practice address
6549 Ditmars St
Las Vegas, NV 89166-8026
Phone
(725) 236-5674
NPI assigned
Mar 19, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2026

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

Authorized official

Name
Chiline Joey Tan-Birket, FNP-CNPI 1689554891
Title
President
Phone
(725) 236-5674

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

6549 Ditmars St
Las Vegas, NV 89166-8026

Mailing address

6549 Ditmars St
Las Vegas, NV 89166-8026
Phone (725) 236-5674

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260521004126 NV Part B Supplier - Clinic/Group Practice 1658841408 Receives reassigned benefits from 1 practitioner
Practice locations: Las Vegas, NV

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1773878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773878400000",
    "number": "1346198975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6549 DITMARS ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891668026",
            "telephone_number": "725-236-5674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6549 DITMARS ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891668026",
            "telephone_number": "725-236-5674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAN AND TAN MEDICAL GROUP PROF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-19",
        "last_updated": "2026-03-19",
        "certification_date": "2026-03-19",
        "status": "A",
        "authorized_official_last_name": "TAN-BIRKET",
        "authorized_official_first_name": "CHILINE",
        "authorized_official_middle_name": "JOEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "725-236-5674",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.