NPIMap

Individual provider Active NPI

Lorena H Tan, MD

  • Family Medicine Physician
  • Livermore, CA
National Provider Identifier
1417957697
Registry record updated Nov 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A61352 Issued in CA
Practice address
1133 E Stanley Blvd
Suite 201
Livermore, CA 94550-4200
Phone
(925) 443-9000
Fax
(925) 443-9009
NPI assigned
Jul 28, 2005
Last updated
Nov 15, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A61352 CA Primary

Addresses

Primary practice location

1133 E Stanley Blvd
Suite 201
Livermore, CA 94550-4200

Mailing address

1133 E Stanley Blvd
Suite 201
Livermore, CA 94550-4200
Phone (925) 443-9000

Other identifiers 1

IdentifierTypeStateIssuer
00A613520MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041227000553 CA Practitioner - Family PracticePractitioner - Emergency Medicine 0648238436 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
University of Southern California Keck School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1133 E Stanley Blvd
Suite 201
Livermore, CA 94550-4246
Phone (925) 443-9000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
28.09 of 100Reported as individual
Quality
15
Improvement activities
0
Cost
73.63

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A61352CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-Valley Family Medicine Family Medicine CurrentSince Nov 1, 2008 Accepting new patients
Pleasanton Emergency Medical Group CurrentSince Feb 3, 2018 Accepting new patients
Stanford Health Care Tri-Valley Past Accepting new patients
Sequoia Health Services Past Accepting new patients
Hill Physicians Medical Group - PPO Program Past Accepting new patients

Locations

4000 Dublin Blvd
Ste 150
Dublin, CA 94568
Phone (813) 732-7842

1111 E Stanley Blvd
Livermore, CA 94550
Phone (925) 373-4018

1133 E Stanley Blvd
Ste 117
Livermore, CA 94550
Phone (925) 371-8885

1133 E Stanley Blvd
Ste 201
Livermore, CA 94550
Phone (925) 443-1311

5555 W Las Positas Blvd
Pleasanton, CA 94588
Phone (925) 416-3418

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479168000000",
    "number": "1417957697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1133 E STANLEY BLVD",
            "address_2": "SUITE 201",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945504200",
            "telephone_number": "925-443-9000",
            "fax_number": "925-443-9009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1133 E STANLEY BLVD",
            "address_2": "SUITE 201",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945504200",
            "telephone_number": "925-443-9000",
            "fax_number": "925-443-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "LORENA",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-28",
        "last_updated": "2016-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A61352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A613520",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Livermore, CA

Sources for this page

Verify at the official NPI Registry.