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ASHLEY JEANINE TAN MD
NPI 1053041509
Family Medicine in Moreno Valley, CA

Active since June 15, 2022PECOS Enrolled
12980 FREDERICK ST STE D, MORENO VALLEY, CA 92553(951) 486-2744 Get Directions Write a Review

NPPES record last updated: July 8, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 8, 2026, Feb 6, 2026, Jul 4, 2023 (3 updates tracked since 2023).

About Ashley Jeanine Tan Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ASHLEY JEANINE TAN MD (NPI 1053041509) is an individual family medicine provider in Moreno Valley, California, licensed in California (A200185) and active in the NPI registry since June 2022. She is enrolled in Medicare PECOS, maintains a secondary practice location in Colton, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1053041509
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameASHLEY JEANINE TANCredential: MD
Location Address12980 FREDERICK ST STE DMoreno Valley, CA 92553-5263
Mailing Address400 N Pepper AveColton, CA 92324-1819 · (909) 580-1000
Phone(951) 486-2744
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateJune 15, 2022
Last NPPES UpdateJuly 8, 20263 updates tracked since enumeration
NPPES CertifiedJuly 8, 2026
✔ NPI 1053041509 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CA · A200185
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
12980 FREDERICK ST STE D, Moreno Valley, CA 92553
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Secondary Practice Location 1

Location 1400 N Pepper AveColton, CA 92324-1819 · Phone (909) 580-1000

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ashley Jeanine Tan Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8729543228
PECOS Enrollment IDI20260724000579
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Ashley Tan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Antonio A. Tan, MD, Professional Corporation
Same address
Clinic/Center
12980 FREDERICK ST, SUITE D
Moreno Valley, CA 92553
  • Reassigned Medicare billing, California enrollment
  • 2 clinicians in this Medicare group
NPI 1003870676 (951) 485-2744

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92553 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$91.88 typical visit price
range $59.60 – $179.42
Typical copayment $22.97 (range $14.90 – $44.85)
Most-billed visit code 99203
Established Patient
$104.64 typical visit price
range $19.37 – $146.42
Typical copayment $26.16 (range $4.84 – $36.60)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HEATHER NICOLE REGULES NP
Nurse Practitioner (Family)
12980 FREDERICK ST STE D
MORENO VALLEY, CA 92553
Riverside County (503) 575-8974

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 Ashley Tan's NPI number?

The NPI number for Ashley Tan is 1053041509. It was assigned to this individual provider in the NPPES registry on June 15, 2022.

Where is Ashley Tan located?

Ashley Tan practices at 12980 Frederick St Ste D, Moreno Valley, CA 92553. The listed phone number is (951) 486-2744.

What is Ashley Tan's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Ashley Tan enrolled in Medicare?

Yes. Ashley Tan is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Ashley Tan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ashley Tan reassigns Medicare benefits to Antonio A. Tan, MD, Professional Corporation (Moreno Valley, CA). The 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 Ashley Tan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Ashley Tan was last updated on July 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.