KINGSLEY TAN PA-C
NPI 1477032621
Physician Assistant in San Diego, CA

Q: What is Kingsley Tan's NPI number?

The NPI number for Kingsley Tan is 1477032621. It was assigned to this individual provider in the NPPES registry on August 8, 2018.

Q: What is Kingsley Tan's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Kingsley Tan was last updated on October 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months 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.

Active since August 08, 2018PECOS EnrolledAccepts Medicare Assignment

200 W ARBOR DR, SAN DIEGO, CA 92103(800) 926-8273(888) 539-8781 Get Directions Write a Review

NPPES record last updated: October 10, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 10, 2025, Aug 8, 2018 (2 updates tracked since 2018).

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About Kingsley Tan Pa-c NPPES

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

KINGSLEY TAN PA-C (NPI 1477032621) is an individual physician assistant in San Diego, California and active in the NPI registry since August 2018. He is enrolled in Medicare PECOS, maintains 7 additional practice locations, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1477032621

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameKINGSLEY TANCredential: PA-C

Location Address200 W ARBOR DRSan Diego, CA 92103-9000

Mailing AddressFile 57326Los Angeles, CA 90074-0001

Phone(800) 926-8273

Fax(888) 539-8781

Sole ProprietorYes

Medical School CMSOtherGraduated 2018

Enumeration DateAugust 8, 2018

Last NPPES UpdateOctober 10, 20252 updates tracked since enumeration

NPPES CertifiedOctober 10, 2025

✔ NPI 1477032621 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

200 W ARBOR DR, San Diego, CA 92103

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Secondary Practice Locations 7

Location 14250 1st AveSan Diego, CA 92103 · Phone (800) 926-8273 · Fax (888) 539-8781

Location 29400 Campus Point DrLA Jolla, CA 92093-1350 · Phone (800) 926-8273 · Fax (888) 539-8781

Location 39300 Campus Point DrLA Jolla, CA 92037-1300 · Phone (800) 926-8273 · Fax (888) 539-8781

Location 4330 Lewis StSan Diego, CA 92103-2108 · Phone (800) 926-8273 · Fax (888) 539-8781

Location 51415 Ross AveEl Centro, CA 92243-4306 · Phone (800) 926-8273 · Fax (888) 539-8781

Location 64829 Fortin StBaldwin Park, CA 91706-1957 · Phone (626) 290-7539

Location 76655 Alvarado RdSan Diego, CA 92120-5208 · Phone (800) 926-8273 · Fax (888) 539-8781

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

Kingsley Tan Pa-c 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 ID840530184

PECOS Enrollment IDI20190322001063

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 92103 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

$94.87 typical visit price

range $62.10 – $184.71

Typical copayment $23.71 (range $15.52 – $46.17)

Most-billed visit code 99203

Established Patient

$76.87 typical visit price

range $20.62 – $151.42

Typical copayment $19.21 (range $5.15 – $37.85)

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. RAMIN MOTARJEMI M.D.

Internal Medicine (Geriatric Medicine)