Individual provider Active NPI

Caroline Tan

  • Dermatology Physician
  • Mountain View, CA
National Provider Identifier
1750842134
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
A181108 Issued in CA
Practice address
2490 Hospital Dr Ste 201
Mountain View, CA 94040-4124
Phone
(650) 962-4600
NPI assigned
Mar 27, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X A181108 CA Primary

Addresses

Primary practice location

2490 Hospital Dr Ste 201
Mountain View, CA 94040-4124

Mailing address

751 S Bascom Ave
San Jose, CA 95128-2604

Other practice location 1

751 S Bascom Ave
San Jose, CA 95128-2604
Phone (973) 517-1574

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
I20230518000919 CA Practitioner - Dermatology 8729444674 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Stanford University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Golden State Dermatology Associates, Inc.Group PAC ID 1052418175, 118 clinicians

Practice addresses (Care Compare)

2490 Hospital Dr
Suite 201
Mountain View, CA 94040-4124
Phone (650) 962-4600

355 Lennon LN
Suite 255
Walnut Creek, CA 94598-2496
Phone (925) 932-7704

Hospital & facility affiliations

  • El Camino Health Hospital, Mountain View, CA, CCN 050308

Merit-based Incentive Payment System (MIPS)

Final score
99.15 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision20
Removal of skin lesions450
Removal or shaving of skin growth1-10
Skin biopsy206

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A181108CAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Golden State Dermatology Associates, Inc. Dermatology CurrentSince Apr 27, 2023 Accepting new patients
Golden State Dermatology Associates, Inc. CurrentSince Apr 27, 2023 Accepting new patients
County of Santa Clara Past Accepting new patients

Locations

1200 Central Blvd
Ste D
Brentwood, CA 94513
Phone (925) 308-9510

2490 Hospital Dr
Ste 201
Mountain View, CA 94040
Phone (650) 285-4661

370 N Wiget Ln
Ste 250
Walnut Creek, CA 94598
Phone (925) 278-7592

355 Lennon Ln
Ste 255
Walnut Creek, CA 94598
Phone (925) 932-7704

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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 3

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": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1750842134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 S BASCOM AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2490 HOSPITAL DR STE 201",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940404124",
            "telephone_number": "650-962-4600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "751 S Bascom Ave",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951282604",
            "country_code": "US",
            "telephone_number": "973-517-1574",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAN",
        "first_name": "CAROLINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-27",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A181108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain View, CA

Sources for this page

Verify at the official NPI Registry.