NICHOLAS GAN TAN D.P.M.
NPI 1346657327
Podiatrist - Foot & Ankle Surgery in Vallejo, CA

Active since July 22, 2014PECOS EnrolledAccepts Medicare Assignment
975 SERENO DR, VALLEJO, CA 94589(909) 633-2881 Get Directions Write a Review

NPPES record last updated: December 6, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Nicholas Gan Tan D.p.m. NPPES

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

NICHOLAS GAN TAN D.P.M. (NPI 1346657327) is an individual foot & ankle surgery provider in Vallejo, California, licensed in California (EL6709) and active in the NPI registry since July 2014. He is enrolled in Medicare PECOS and is a graduate of Temple University School Of Medicine (2014).

NPPES Registry Identity

NPI1346657327
Entity TypeIndividualMale
Primary Taxonomy213ES0103X
Provider Legal NameNICHOLAS GAN TANCredential: D.P.M.
Location Address975 SERENO DRVallejo, CA 94589-2441
Mailing Address521 Greenbriar CirPetaluma, CA 94954-3528 · (909) 633-2881
Sole ProprietorNo
Medical School CMSTemple University School Of MedicineGraduated 2014
Enumeration DateJuly 22, 2014
Last NPPES UpdateDecember 6, 2021
NPI 1346657327 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPodiatrist · Foot & Ankle SurgeryPodiatric Medicine & Surgery Service Providers
Taxonomy Code213ES0103X
License Licensed in CA · EL6709
975 SERENO DR, Vallejo, CA 94589

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Nicholas Gan Tan D.p.m. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2860735396
PECOS Enrollment IDI20190523001856
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.

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.

Physical Medicine & Rehabilitation
975 SERENO DR
VALLEJO, CA 94589
Pharmacist
975 SERENO DR
VALLEJO, CA 94589
Student in an Organized Health Care Education/Training Program
975 SERENO DR
VALLEJO, CA 94589
Social Worker (Clinical)
975 SERENO DR
VALLEJO, CA 94589
Student in an Organized Health Care Education/Training Program
975 SERENO DR
VALLEJO, CA 94589
Anesthesiology
975 SERENO DR
VALLEJO, CA 94589
Family Medicine
975 SERENO DR
VALLEJO, CA 94589
Surgery
975 SERENO DR
VALLEJO, CA 94589

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 Nicholas Tan's NPI number?

The NPI number for Nicholas Tan is 1346657327. It was assigned to this individual provider in the NPPES registry on July 22, 2014.

Where is Nicholas Tan located?

Nicholas Tan practices at 975 Sereno Dr, Vallejo, CA 94589. The listed phone number is (909) 633-2881.

What is Nicholas Tan's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.

Is Nicholas Tan enrolled in Medicare?

Yes. Nicholas Tan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Nicholas Tan was last updated on December 6, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.