Individual provider Active NPI

Tiffany L Chan, M.D.

  • Diagnostic Radiology Physician
  • Los Angeles, CA
National Provider Identifier
1457796518
Registry record updated Dec 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A154773 Issued in CA
Practice address
757 Westwood PLZ Ste 1638
Los Angeles, CA 90095-3412
Phone
(310) 267-8796
Fax
(310) 267-2059
NPI assigned
May 2, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A154773 CA Primary

Addresses

Primary practice location

757 Westwood PLZ Ste 1638
Los Angeles, CA 90095-3412

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other practice location 1

1245 16th St Ste 100
Santa Monica, CA 90404-1255
Phone (310) 301-6800

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
I20180607001245 CA Practitioner - Diagnostic Radiology 7517222854 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Albany Medical College of Union University, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
UCLA Radiology Medical GroupGroup PAC ID 8921902065, 193 clinicians

Practice addresses (Care Compare)

100 Medical Plaza
Los Angeles, CA 90095-0001
Phone (310) 301-6800

1223 16TH St
Santa Monica, CA 90404-1217
Phone (310) 566-1474

1260 15TH St
Suite 111
Santa Monica, CA 90404-1136
Phone (310) 393-5153

200 Medical Plaza
Los Angeles, CA 90095-0001
Phone (310) 301-6800

2200 N Sepulveda Blvd
Manhattan Beach, CA 90266-2910
Phone (310) 802-0200

300 Medical Plaza
Los Angeles, CA 90095-0001
Phone (310) 301-6800

300 UCLA Medical PLZ
Suite B130
Los Angeles, CA 90095-8346
Phone (310) 206-0456

30700 Russell Ranch Rd
Suite 110
Westlake Village, CA 91362-9500
Phone (818) 661-6570

4323 Riverside Dr
Burbank, CA 91505-4044
Phone (818) 556-2700

4343 Lankershim Blvd
North Hollywood, CA 91602-2705

700 W 7TH St
Suite S270 D
Los Angeles, CA 90017-3768
Phone (213) 988-8339

7325 Medical Ctr Dr
Suite 106
West Hills, CA 91307-4109
Phone (818) 676-4000

757 Westwood PLZ
Los Angeles, CA 90095-8358
Phone (310) 825-9111

Hospital & facility affiliations

  • Ronald Reagan UCLA Medical Center Hospital, Los Angeles, CA, CCN 050262
  • UCLA West Valley Medical Center Hospital, West Hills, CA, CCN 050481
  • Santa Monica - UCLA Med Ctr & Orthopaedic Hospital Hospital, Santa Monica, CA, CCN 050112
  • Cedars-Sinai Medical Center Hospital, Los Angeles, CA, CCN 050625

Merit-based Incentive Payment System (MIPS)

Final score
88.39 of 100Reported as group
Quality
87.27
Promoting interoperability
100
Improvement activities
40
Cost
74.04

Merit-based Incentive Payment System (MIPS)

Final score
81.13 of 100Reported as group
Quality
62.91
Promoting interoperability
100
Improvement activities
40
Cost
68.15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A154773CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Martin Luther King Jr Community Medical Foundation CurrentSince Nov 7, 2018 Accepting new patients
Regents of the University of California CurrentSince Jul 1, 2018 Accepting new patients
UCLA Radiology Medical Group Diagnostic Radiology CurrentSince Jul 1, 2018 Accepting new patients
County of Los Angeles CurrentSince Jul 15, 2018 Accepting new patients
County of Los Angeles CurrentSince Jul 15, 2018 Accepting new patients
Martin Luther King Jr Community Medical Foundation CurrentSince Nov 7, 2018 Accepting new patients
Regents of the University of California CurrentSince Jul 1, 2018 Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients

Locations

2215 W Rosecrans Ave
Ste 22
Compton, CA 90222
Phone (424) 529-6755

1000 Flower St
Glendale, CA 91201
Phone (818) 659-5000

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

100 Medical Plz
Ste 170
Los Angeles, CA 90095
Phone (415) 353-2808

300 UCLA Medical Plz
Ste B130
Los Angeles, CA 90095
Phone (310) 206-0456

757 Westwood Plz
Ste 1638
Los Angeles, CA 90095
Phone (310) 267-8796

10833 Le Conte Ave
Los Angeles, CA 90095
Phone (310) 301-8932

File 59755
Los Angeles, CA 90074

1250 16th St
Santa Monica, CA 90404
Phone (310) 301-8695

1245 16th St
Ste 100
Santa Monica, CA 90404

14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303

100 Moody Ct
Thousand Oaks, CA 91360
Phone (805) 418-3500

Interoperability endpoints

  • Direct secure messaging: tchan625321@direct.uclahealth.org

Organizations & group practices 8

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 5

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": "1367452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575936000000",
    "number": "1457796518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 WESTWOOD PLZ STE 1638",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900953412",
            "telephone_number": "310-267-8796",
            "fax_number": "310-267-2059"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1245 16th St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904041255",
            "country_code": "US",
            "telephone_number": "310-301-6800",
            "fax_number": "310-794-9035",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAN",
        "first_name": "TIFFANY",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-02",
        "last_updated": "2019-12-10",
        "certification_date": "2019-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A154773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.