Individual provider Active NPI

Vinson Tan, PT, DPT

  • Physical Therapist
  • Daly City, CA
National Provider Identifier
1881285609
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
299589 Issued in CA
Practice address
1850 Sullivan Ave Ste 330
Daly City, CA 94015-2204
Phone
(650) 756-5630
NPI assigned
Feb 3, 2021
Last updated
Jan 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 299589 CA Primary

Addresses

Primary practice location

1850 Sullivan Ave Ste 330
Daly City, CA 94015-2204

Mailing address

807 Athens St
San Francisco, CA 94112-3811
Phone (415) 963-1769

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240315000789 CA Practitioner - Physical Therapist in Private Practice 4082050786 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peninsula Orthopedic Associates IncGroup PAC ID 7719974336, 18 clinicians

Practice addresses (Care Compare)

455 Hickey Blvd
Suite 205
Daly City, CA 94015-2630
Phone (650) 756-5630

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
299589CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peninsula Orthopedic Associates, Inc. CurrentSince Sep 18, 2023 Accepting new patients

Locations

1850 Sullivan Ave
Ste 330
Daly City, CA 94015
Phone (650) 756-5630

455 Hickey Blvd
Ste 205
Daly City, CA 94015
Phone (650) 746-3299

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1612310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1881285609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 ATHENS ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941123811",
            "telephone_number": "415-963-1769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 SULLIVAN AVE STE 330",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152204",
            "telephone_number": "650-756-5630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "VINSON",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-03",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "299589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daly City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.