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LANCY MIMI TAN MD
NPI 1073044301
Surgery in Shoreline, WA

Active since March 27, 2017PECOS Enrolled
19930 BALLINGER WAY NE, SHORELINE, WA 98155(425) 778-2220(425) 778-7701 Get Directions Write a Review

NPPES record last updated: April 5, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 5, 2024, Mar 27, 2017 (2 updates tracked since 2017).

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

NPI1073044301
Entity TypeIndividualFemale
Primary Taxonomy208600000X
Provider Legal NameLANCY MIMI TANCredential: MD
Location Address19930 BALLINGER WAY NEShoreline, WA 98155-1223
Mailing Address19930 Ballinger Way NeShoreline, WA 98155-1223 · (425) 778-2220 · Fax (425) 778-7701
Phone(425) 778-2220
Fax(425) 778-7701
Sole ProprietorNo
Enumeration DateMarch 27, 2017
Last NPPES UpdateApril 5, 20242 updates tracked since enumeration
NPPES CertifiedApril 5, 2024
✔ NPI 1073044301 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
Licenses✔ Licensed in WA · MD61170965✔ Licensed in OR · MD210187
Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

19930 BALLINGER WAY NE, Shoreline, WA 98155
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Premera Blue Cross Blue Shield of Alaska, Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

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.

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.

New Patient
$97.43 typical visit price
range $63.67 – $189.37
Typical copayment $24.35 (range $15.91 – $47.34)
Most-billed visit code 99203
Established Patient
$78.74 typical visit price
range $21.12 – $155.00
Typical copayment $19.68 (range $5.28 – $38.75)
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.

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.

DR. JEDEDIAH A KAUFMAN MD
Surgery
19930 BALLINGER WAY NE
SHORELINE, WA 98155
King County (425) 778-2220
JULIA ENGEL MS, RD, CD
Dietitian, Registered
19930 BALLINGER WAY NE
SHORELINE, WA 98155
King County (425) 778-2220
THE MULTISPECIALTY SURGENCY CENTER, LLC
Clinic/Center (Ambulatory Surgical)
19930 BALLINGER WAY NE
SHORELINE, WA 98155
King County (206) 957-8128
ALVINA WON MD
Surgery
19930 BALLINGER WAY NE
SHORELINE, WA 98155
King County (425) 778-2220
BRANDON WILLEM VANDERWEL M.D.
Surgery
19930 BALLINGER WAY NE
SHORELINE, WA 98155
King County (425) 778-2220
MRS. KATRINA ANN BURKHOLDER OTRL OCCUPATIONAL TH
Occupational Therapist
19930 BALLINGER WAY NE
SHORELINE, WA 98155
King County (206) 363-6947
DOMINIC K ROSSBOTHAM RN-FIRST SURGICAL AS
Orthopaedic Surgery (Hand Surgery)
19930 BALLINGER WAY NE
SEATTLE, WA 98155
King County (206) 363-6947
MS. PATRICIA A. CLEMENT R.D., C.D., C.D.E.
Dietitian, Registered
19930 BALLINGER WAY NE
SHORELINE, WA 98155
King County (425) 778-2220

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.

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 with the weekly NPPES data releases published by CMS.