LANCY MIMI TAN MD
NPI 1073044301
Surgery in Shoreline, WA
About Lancy Mimi Tan Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LANCY MIMI TAN MD (NPI 1073044301) is an individual surgery provider in Shoreline, Washington, licensed in Washington (MD61170965) and active in the NPI registry since March 2017. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Lancy Mimi Tan Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Lancy Tan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Portland, OR 97210
- Reassigned Medicare billing, Oregon enrollment
- 387 clinicians in this Medicare group
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 98155 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SHORELINE, WA 98155
SHORELINE, WA 98155
SEATTLE, WA 98155
SHORELINE, WA 98155
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 Lancy Tan's NPI number?
The NPI number for Lancy Tan is 1073044301. It was assigned to this individual provider in the NPPES registry on March 27, 2017.
Where is Lancy Tan located?
Lancy Tan practices at 19930 Ballinger Way NE, Shoreline, WA 98155. The listed phone number is (425) 778-2220.
What is Lancy Tan's specialty?
The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.
Is Lancy Tan enrolled in Medicare?
Yes. Lancy Tan is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Lancy Tan's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Lancy Tan reassigns Medicare benefits to Legacy Good Samaritan Hospital And Medical Center (Portland, OR). 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 Lancy Tan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Lancy Tan accept?
Health plans from Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Lancy Tan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Lancy Tan was last updated on April 5, 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.
# Lancy Mimi Tan, MD · NPI 1073044301
Surgery physician in Shoreline, Washington. Individual provider, active in the CMS NPPES registry since March 27, 2017.
## Identity
- **NPI:** 1073044301 (Entity type: Individual)
- **Enumerated:** March 27, 2017
- **Primary specialty:** Surgery · taxonomy 208600000X
- **State license:** MD61170965 (Washington)
- **Sole proprietor:** No
## Practice location
- **Address:** 19930 BALLINGER WAY NE, Shoreline, WA 98155-1223
- **Phone:** (425) 778-2220 · **Fax:** (425) 778-7701
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Legacy Good Samaritan Hospital And Medical Center (NPI 1679597108, Portland, OR), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 5, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1073044301) · Data from the CMS NPPES public registry.