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MR. PHILLIP GEORGE TARDANICO LCSW 69611
NPI 1063871291
Social Worker - Clinical in Victorville, CA

Active since February 16, 2016PECOS Enrolled
15000 SEVENTH ST STE 209, VICTORVILLE, CA 92395(760) 217-9527(442) 267-5623 Get Directions Write a Review

NPPES record last updated: June 4, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 4, 2024, Mar 31, 2021, Jun 11, 2020 and 2 more (5 updates tracked since 2016).

About Mr. Phillip George Tardanico Lcsw 69611 NPPES

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

MR. PHILLIP GEORGE TARDANICO LCSW 69611 (NPI 1063871291) is an individual clinical provider in Victorville, California, licensed in California (LCSW69611) and active in the NPI registry since February 2016. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2001).

NPPES Registry Identity

NPI1063871291
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMR. PHILLIP GEORGE TARDANICOCredential: LCSW 69611
Location Address15000 SEVENTH ST STE 209Victorville, CA 92395-3853
Mailing Address15000 Seventh St Ste 209Victorville, CA 92395-3853 · (760) 217-9527 · Fax (442) 267-5623
Phone(760) 217-9527
Fax(442) 267-5623
Sole ProprietorNo
Medical School CMSOtherGraduated 2001
Enumeration DateFebruary 16, 2016
Last NPPES UpdateJune 4, 20245 updates tracked since enumeration
NPPES CertifiedJune 4, 2024
✔ NPI 1063871291 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in CA · LCSW69611
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License A01210315 (CA)
15000 SEVENTH ST STE 209, Victorville, CA 92395
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Other Names 1

Professional Name (2)Mr. Phillip Tardanico Lcsw, Mac, & Sap

Secondary Practice Locations 2

Location 11738 N Waterman Ave Ste 3San Bernardino, CA 92404-5131 · Phone (760) 217-9527
Location 215000 Seventh St Ste 203Victorville, CA 92395-3851 · Phone (760) 217-9527

Other Identifiers 1

Medicaid800682649CA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Phillip George Tardanico Lcsw 69611 is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID547502270
PECOS Enrollment IDI20190430001195
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 Reassignments

2

Medicare enrollment records show Phillip Tardanico reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Phillip Tardanico, Licensed Clinical Social Worker & Associates, PC
Same address
Clinical
15000 7TH ST STE 209
Victorville, CA 92395
  • Reassigned Medicare billing, California enrollment
  • 2 clinicians in this Medicare group
NPI 1063020717 (760) 217-9527
Sud Specialty Group - Ca
328 mi
Addiction Medicine
4633 OLD IRONSIDES DR STE 304
Santa Clara, CA 95054
  • Reassigned Medicare billing, California enrollment
  • 1,607 clinicians in this Medicare group
NPI 1972138238 (323) 205-7088

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 92395 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
$0.00 typical visit price
range $59.60 – $179.42
Typical copayment $0.00 (range $14.90 – $44.85)
Most-billed visit code NA
Established Patient
$74.08 typical visit price
range $19.37 – $146.42
Typical copayment $18.52 (range $4.84 – $36.60)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Phillip Tardanico's NPI number?

The NPI number for Phillip Tardanico is 1063871291. It was assigned to this individual provider in the NPPES registry on February 16, 2016. The provider is also known as Mr. Phillip Tardanico Lcsw, Mac, & Sap.

Where is Phillip Tardanico located?

Phillip Tardanico practices at 15000 Seventh St Ste 209, Victorville, CA 92395. The listed phone number is (760) 217-9527.

What is Phillip Tardanico's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Phillip Tardanico enrolled in Medicare?

Yes. Phillip Tardanico is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Phillip Tardanico's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Phillip Tardanico reassigns Medicare benefits to 2 organizations: Phillip Tardanico, Licensed Clinical Social Worker & Associates, PC (Victorville, CA) and Sud Specialty Group - Ca (Santa Clara, CA). Each 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 Phillip Tardanico'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 Phillip Tardanico was last updated on June 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.