ANTONIO A. TAN, MD, PROFESSIONAL CORPORATION
NPI 1003870676
Clinic/Center in Moreno Valley, CA
About Antonio A. Tan, Md, Professional Corporation NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ANTONIO A. TAN, MD, PROFESSIONAL CORPORATION (NPI 1003870676) is a healthcare organization registered as a clinic/center in Moreno Valley, California and active in the NPI registry since April 2006. The organization lists Rhoda J. Tan, Manager / Secretary Of P.c., as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Antonio A. Tan, Md, Professional Corporation is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Antonio A. Tan, MD, Professional Corporation, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
Moreno Valley, CA 92553
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Antonio A. Tan, MD, Professional Corporation's NPI number?
The NPI number for Antonio A. Tan, MD, Professional Corporation is 1003870676. It was assigned to this organization in the NPPES registry on April 12, 2006.
Where is Antonio A. Tan, MD, Professional Corporation located?
Antonio A. Tan, MD, Professional Corporation is located at 12980 Frederick St Suite D, Moreno Valley, CA 92553. The listed phone number is (951) 485-2744.
What is Antonio A. Tan, MD, Professional Corporation's specialty?
The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.
Is Antonio A. Tan, MD, Professional Corporation enrolled in Medicare?
Yes. Antonio A. Tan, MD, Professional Corporation is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Antonio A. Tan, MD, Professional Corporation?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Antonio A. Tan, MD, Professional Corporation, in Family Practice and Internal Medicine. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Antonio A. Tan, MD, Professional Corporation was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Antonio A. Tan, Md, Professional Corporation · NPI 1003870676
Clinic/Center organization in Moreno Valley, California. Organization record, active in the CMS NPPES registry since April 12, 2006.
## Identity
- **NPI:** 1003870676 (Entity type: Organization)
- **Enumerated:** April 12, 2006
- **Primary specialty:** Clinic/Center · taxonomy 261Q00000X
- **Organization subpart:** No
- **Authorized official:** Rhoda Tan, MANAGER / SECRETARY OF P.C.
## Practice location
- **Address:** 12980 FREDERICK ST, SUITE D, Moreno Valley, CA 92553-5263
- **Phone:** (951) 485-2744 · **Fax:** (951) 485-2749
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (1), Internal Medicine (1); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 22, 2020
- **Other identifiers:** Medicaid 00A454161 (CA)
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Source: [NPI Profile](https://npiprofile.com/npi/1003870676) · Data from the CMS NPPES public registry.