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TRI-VALLEY FAMILY MEDICINE
NPI 1245483759
Family Medicine in Livermore, CA

Active since October 28, 2008CLIA 05D1094609 · Waiver
1133 E STANLEY BLVD, SUITE 201, LIVERMORE, CA 94550(925) 443-9000(925) 443-9009 Get Directions Write a Review

NPPES record last updated: November 15, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Tri-valley Family Medicine NPPES

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

TRI-VALLEY FAMILY MEDICINE (NPI 1245483759) is a healthcare organization registered as a family medicine in Livermore, California and active in the NPI registry since October 2008. The organization holds a CLIA Waiver certificate valid through January 21, 2027 and lists Lorena H Tan, Owner, as its authorized official.

NPPES Registry Identity

NPI1245483759
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameTRI-VALLEY FAMILY MEDICINE
Location Address1133 E STANLEY BLVD, SUITE 201Livermore, CA 94550-4200
Mailing Address1133 E Stanley Blvd, Suite 201Livermore, CA 94550-4200 · (925) 443-9000 · Fax (925) 443-9009
Phone(925) 443-9000
Fax(925) 443-9009
Organization SubpartNo
Authorized OfficialLorena H TanOwner · (925) 443-9000
Enumeration DateOctober 28, 2008
Last NPPES UpdateNovember 15, 2016
✔ NPI 1245483759 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 · A61352
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.
1133 E STANLEY BLVD, Livermore, CA 94550
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Other Identifiers 3

Medicare UPING83156CA
Medicaid00A613520CA
Medicare PIN00A613522CA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tri-valley Family Medicine is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Tri-Valley Family Medicine, which bills Medicare for the services this clinician delivers.

Clinician (1)

Lorena Tan, MD
Family Practice
NPI 1417957697
1133 E STANLEY BLVD SUITE 201
Livermore, CA 94550
(925) 443-9000
✔ PECOS✔ Accepts MedicareSame address

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D1094609

Tri-Valley Family Medicine · Livermore, CA
Active · expires Jan 21, 2027
CLIA Number05D1094609
Laboratory TypePhysician Office
Certificate Effective DateJanuary 22, 2025
Certificate Expiration DateJanuary 21, 2027
Laboratory DirectorLorena H. Tan, MD
Laboratory Phone(925) 443-9000
Laboratory LocationTri-Valley Family Medicine1133 E Stanley Blvd Ste 201, Livermore, CA 94550
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Tri-Valley Family Medicine's NPI number?

The NPI number for Tri-Valley Family Medicine is 1245483759. It was assigned to this organization in the NPPES registry on October 28, 2008.

Where is Tri-Valley Family Medicine located?

Tri-Valley Family Medicine is located at 1133 E Stanley Blvd Suite 201, Livermore, CA 94550. The listed phone number is (925) 443-9000.

What is Tri-Valley Family Medicine's specialty?

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

Is Tri-Valley Family Medicine enrolled in Medicare?

Yes. Tri-Valley Family Medicine is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Tri-Valley Family Medicine?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Tri-Valley Family 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Tri-Valley Family Medicine hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D1094609) is associated with this NPI, valid through January 21, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Tri-Valley Family Medicine was last updated on November 15, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.