Michelle Tan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA63147 Issued in CA

Practice address

300 Stein Plaza Suite 420
Los Angeles, CA 90095-0001

Phone

(310) 825-5111

NPI assigned

Dec 27, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Eastern Virginia Medical School, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Regents of the University of CaliforniaGroup PAC ID 1355249491, 43 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ronald Reagan UCLA Medical Center Hospital, Los Angeles, CA, CCN 050262

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mtan1417172@direct.uclahealth.org

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.

• The Regents of the University of California

  • Neurological Surgery Physician
  • Los Angeles, CA
  • NPI 1538125844
  Medicare reassignment Care Compare group
• Kern County Hospital Authority

  • General Acute Care Hospital
  • Bakersfield, CA
  • NPI 1376623538
  Medicare reassignment NPD
• The Regents of the University of California

  • Durable Medical Equipment & Medical Supplies
  • Los Angeles, CA
  • NPI 1447027677
  NPD

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

• Regents Univ of Calif Los Angeles

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1902803315
  Care Compare affiliation

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

{
    "created_epoch": "1672099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1689387490",
    "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": "300 STEIN PLAZA SUITE 420",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900950001",
            "telephone_number": "310-825-5111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 Mt. Vernon Ave.",
            "address_2": "Department of Surgery",
            "address_purpose": "LOCATION",
            "city": "Bakersfield",
            "state": "CA",
            "postal_code": "93306",
            "country_code": "US",
            "telephone_number": "661-326-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAN",
        "first_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-27",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA63147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maebel Tan, FNP-BC
• Marian Martha Depatillo Tan, PHARMD
• Mark Vincent Syki Tan
• Matthew S Tan, M.D.
• Michael Hock En Tan
• Mitchell Ejercito Tan, RN
• Nelly Tan, MD
• Nemuel Biejay Tan, DC
• Olivia Campbell Tan, M.S., C.G.C.
• Patricia Z Tan, PH.D.

• Physician Assistant in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2025; 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.