Active NPI
Diane Tan, PA-C
- Physician Assistant
- West Covina, CA
National Provider Identifier
1699144618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 52826
- Practice address
- 1115 S Sunset Ave
West Covina, CA 91790-3940 - Phone
- (626) 962-4011
- NPI assigned
- Sep 21, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 52826 | CA | Primary |
Addresses
Primary practice location
1115 S Sunset Ave
West Covina, CA 91790-3940
Mailing address
11625 Cantlay St
North Hollywood, CA 91605-3941
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: No
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 96.69 of 100
- Quality
- 90
- Improvement activities
- 40
- Cost
- 78.43
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cep America - California | Current | Accepting new patients |
Locations
2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051
1115 S Sunset Ave
West Covina, CA 91790
Phone (626) 814-2434
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452470400000",
"number": "1699144618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11625 CANTLAY ST",
"city": "NORTH HOLLYWOOD",
"state": "CA",
"postal_code": "916053941"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1115 S SUNSET AVE",
"city": "WEST COVINA",
"state": "CA",
"postal_code": "917903940",
"telephone_number": "626-962-4011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAN",
"first_name": "DIANE",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-21",
"last_updated": "2016-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "52826",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in West Covina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2016; 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.