JACK TANG PA - NPI 1619777901 - Physician Assistant in Sacramento, CA

Q: What is Jack Tang's NPI number?

The NPI number for Jack Tang is 1619777901. It was assigned to this individual provider in the NPPES registry on March 15, 2025.

Q: What is Jack Tang'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 Jack Tang was last updated on June 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 45 days 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.

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About Jack Tang Pa NPPES

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

JACK TANG PA (NPI 1619777901) is an individual physician assistant in Sacramento, California, licensed in California (PA67316) and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1619777901

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameJACK TANGCredential: PA

Location Address3030 EXPLORER DRSacramento, CA 95827-2728

Mailing Address3030 Explorer DrSacramento, CA 95827-2728 · (916) 642-1867 · Fax (844) 491-6066

Phone(916) 642-1867

Fax(844) 491-6066

Sole ProprietorNo

Enumeration DateMarch 15, 2025

Last NPPES UpdateJune 21, 20264 updates tracked since enumeration

NPPES CertifiedJune 21, 2026

✔ NPI 1619777901 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in CA · PA67316

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.

3030 EXPLORER DR, Sacramento, CA 95827

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jack Tang Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 95827 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

$92.61 typical visit price

range $60.44 – $180.85

Typical copayment $23.15 (range $15.11 – $45.21)

Most-billed visit code 99203

Established Patient

$75.03 typical visit price

range $19.88 – $148.15

Typical copayment $18.75 (range $4.97 – $37.03)

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 14

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

HOJUN PARK DDS

Dentist (General Practice)