Connie Tan, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

33425 Issued in CA

Practice address

477 N El Camino Real Ste C202
Encinitas, CA 92024-1332

Phone

(760) 631-3500

NPI assigned

Jun 24, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Optometry

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carmel Mountain Vision Care IncGroup PAC ID 8921034984, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.31 of 100Reported as group

Quality

93.27

Improvement activities

40

Cost

76.67

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: connie.tan.p1@direct.morriseyegroup.nextgenshare.com

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.

• Carmel Mountain Vision Care Optometry, Inc

  • Optometrist
  • San Diego, CA
  • NPI 1922103688
  Medicare reassignment Care Compare group NPD
• Eyecare Solutions Inc

  • Ophthalmology Physician
  • Encinitas, CA
  • NPI 1467519470
  Medicare reassignment NPD

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

{
    "created_epoch": "1466726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594771200000",
    "number": "1609227222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7637 HEATHERLY LN",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921305602",
            "telephone_number": "909-569-3780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 N EL CAMINO REAL STE C202",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920241332",
            "telephone_number": "760-631-3500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "33 W 42nd St",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100368005",
            "country_code": "US",
            "telephone_number": "212-938-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAN",
        "first_name": "CONNIE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-24",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "08446",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Toshizumi Takahashi
• Atsuhiko Takizawa, PHARM.D
• Talky Tots
• Catherine Y. Tan, O.D.
• Charity L Tan, N.P.
• Giniena Tan, LEP, PPS
• Michelle Tang, PHARM.D.
• Alan Tanitsky
• Diana Tannous
• Richard John Tannyhill Jr., D.D.S.

• Optometrist in Encinitas, CA
• Providers in Encinitas, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.