DR. GORDON TAN M.D.
NPI 1659662583
Pediatrics in Moreno Valley, CA

Q: What is Gordon Tan's NPI number?

The NPI number for Gordon Tan is 1659662583. It was assigned to this individual provider in the NPPES registry on April 26, 2011.

Q: What is Gordon Tan's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Q: When was this NPI record last updated?

The NPPES record for Gordon Tan was last updated on November 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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 26, 2011PECOS Enrolled

12815 HEACOCK ST, MORENO VALLEY, CA 92553(951) 601-6399 Get Directions Write a Review

NPPES record last updated: November 30, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

On this page

About Dr. Gordon Tan M.d. NPPES

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

DR. GORDON TAN M.D. (NPI 1659662583) is an individual pediatrics provider in Moreno Valley, California, licensed in California (A122192) and active in the NPI registry since April 2011. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1659662583

Entity TypeIndividualMale

Primary Taxonomy208000000X

Provider Legal NameDR. GORDON TANCredential: M.D.

Location Address12815 HEACOCK STMoreno Valley, CA 92553-2836

Mailing Address12815 Heacock StMoreno Valley, CA 92553-2836

Phone(951) 601-6399

Sole ProprietorNo

Enumeration DateApril 26, 2011

Last NPPES UpdateNovember 30, 2024

NPPES CertifiedNovember 30, 2024

✔ NPI 1659662583 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in CA · A122192

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

12815 HEACOCK ST, Moreno Valley, CA 92553

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Gordon Tan M.d. 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.

Medicare Billing Reassignments

Medicare enrollment records show Gordon Tan reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Faculty Physicians And Surgeons Of Llusm

0.9 mi

Ophthalmology

23000 ATLANTIC CIR
Moreno Valley, CA 92553

Reassigned Medicare billing, California enrollment
2,584 clinicians in this Medicare group

NPI 1437555612 (909) 558-3111

County Of San Bernardino

8.9 mi

Adult Mental Health

1330 E COOLEY DR
Colton, CA 92324

Reassigned Medicare billing, California enrollment
233 clinicians in this Medicare group

NPI 1982813275 (909) 580-3705

Southern California Permanente Medical Group

13 mi

Health Maintenance Organization

10800 MAGNOLIA AVE
Riverside, CA 92505

Reassigned Medicare billing, California enrollment
5,228 clinicians in this Medicare group

NPI 1316979834 (866) 984-7483

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 92553 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

$91.88 typical visit price

range $59.60 – $179.42

Typical copayment $22.97 (range $14.90 – $44.85)

Most-billed visit code 99203

Established Patient

$104.64 typical visit price

range $19.37 – $146.42

Typical copayment $26.16 (range $4.84 – $36.60)

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 20

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

CAITLIN THU CHAU M.D.

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