MR. KEITH JOHN TANENBAUM LCSW
NPI 1477169605
Social Worker - Clinical in South Lake Tahoe, CA
About Mr. Keith John Tanenbaum Lcsw NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. KEITH JOHN TANENBAUM LCSW (NPI 1477169605) is an individual clinical provider in South Lake Tahoe, California, licensed in California (107974) and active in the NPI registry since September 2020. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2017).
NPPES Registry Identity
Specialties & Licenses 3
Secondary Practice Locations 2
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
Mr. Keith John Tanenbaum Lcsw 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 96150 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Keith Tanenbaum's NPI number?
The NPI number for Keith Tanenbaum is 1477169605. It was assigned to this individual provider in the NPPES registry on September 22, 2020.
Where is Keith Tanenbaum located?
Keith Tanenbaum practices at 924 Emerald Bay Rd First Floor, South Lake Tahoe, CA 96150. The listed phone number is (530) 782-9889.
What is Keith Tanenbaum's specialty?
The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.
Is Keith Tanenbaum enrolled in Medicare?
Yes. Keith Tanenbaum 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 Keith Tanenbaum was last updated on October 5, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Mr. Keith John Tanenbaum, LCSW · NPI 1477169605
Clinical provider in South Lake Tahoe, California. Individual provider, active in the CMS NPPES registry since September 22, 2020.
## Identity
- **NPI:** 1477169605 (Entity type: Individual)
- **Enumerated:** September 22, 2020
- **Primary specialty:** Social Worker - Clinical · taxonomy 1041C0700X
- **State license:** 107974 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 924 EMERALD BAY RD, FIRST FLOOR, South Lake Tahoe, CA 96150
- **Phone:** (530) 782-9889
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Medical school:** Other, class of 2017
## Record status
- **NPPES last updated:** October 5, 2022
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Source: [NPI Profile](https://npiprofile.com/npi/1477169605) · Data from the CMS NPPES public registry.