LILY RAVEL VAN TONGEREN MD
NPI 1609516046
Family Medicine in Santa Monica, CA

Q: What is Lily Van Tongeren's NPI number?

The NPI number for Lily Van Tongeren is 1609516046. It was assigned to this individual provider in the NPPES registry on April 1, 2022.

Q: What is Lily Van Tongeren's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Lily Van Tongeren was last updated on July 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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 April 01, 2022PECOS EnrolledAccepts Medicare Assignment

1245 16TH ST STE 309, SANTA MONICA, CA 90404(310) 319-4377 Get Directions Write a Review

NPPES record last updated: July 2, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 2, 2025, Jun 20, 2025 (2 updates tracked since 2025).

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About Lily Ravel Van Tongeren Md NPPES

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

LILY RAVEL VAN TONGEREN MD (NPI 1609516046) is an individual family medicine provider in Santa Monica, California, licensed in California (A200941) and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS, maintains 3 additional practice locations, and is a graduate of Drexel University College Of Medicine (2022).

NPPES Registry Identity

NPI1609516046

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameLILY RAVEL VAN TONGERENCredential: MD

Location Address1245 16TH ST STE 309Santa Monica, CA 90404-1239

Mailing Address5767 W Century Blvd Ste 400Los Angeles, CA 90045-5631 · (310) 301-5200

Phone(310) 319-4377

Sole ProprietorNo

Medical School CMSDrexel University College Of MedicineGraduated 2022

Enumeration DateApril 1, 2022

Last NPPES UpdateJuly 2, 20252 updates tracked since enumeration

NPPES CertifiedJuly 2, 2025

✔ NPI 1609516046 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in CA · A200941

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.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1245 16TH ST STE 309, Santa Monica, CA 90404

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Secondary Practice Locations 3

Location 18641 Wilshire Blvd Ste 115Beverly Hills, CA 90211-2919 · Phone (310) 855-7002 · Fax (310) 855-7003

Location 21625 Schrader BlvdLos Angeles, CA 90028-6213 · Phone (323) 993-7500

Location 31399 Roxbury Dr Ste 100Los Angeles, CA 90035-4709 · Phone (310) 557-2273

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

Lily Ravel Van Tongeren Md 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 ID7719406578

PECOS Enrollment IDI20250523002019

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 90404 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

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

Most-billed visit code 99214

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 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOSHUA KHALILI MD

Internal Medicine