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 and maintains 2 additional practice locations.
NPPES Registry Identity
Specialties & Licenses 3
Secondary Practice Locations 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mr. Keith John Tanenbaum Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Keith Tanenbaum reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
South Lake Tahoe, CA 96150
- Reassigned Medicare billing, California enrollment
- 148 clinicians in this Medicare group
South Lake Tahoe, CA 96150
- Reassigned Medicare billing, California enrollment
- 100 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 3
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 enrollment system.
Which organizations bill Medicare for Keith Tanenbaum's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Keith Tanenbaum reassigns Medicare benefits to 2 organizations: Barton Medical Foundation (South Lake Tahoe, CA) and Tahoe Carson Valley Medical Group Inc (South Lake Tahoe, CA). Each 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 Keith Tanenbaum's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
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 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.
# 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 in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Barton Medical Foundation (NPI 1750950499, South Lake Tahoe, CA); Tahoe Carson Valley Medical Group Inc (NPI 1508865528, South Lake Tahoe, CA) · CMS Revalidation Reassignment List, October 2026 release
## 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.