CONNIE YI QING TAN NP
NPI 1679211015
Nurse Practitioner - Family in Daly City, CA
About Connie Yi Qing Tan Np NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CONNIE YI QING TAN NP (NPI 1679211015) is an individual family provider in Daly City, California, licensed in California (NP95020349) and active in the NPI registry since May 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2021).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Connie Yi Qing Tan Np 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.
Medicare Billing Reassignments
2Medicare enrollment records show Connie Tan reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Daly City, CA 94015
- Reassigned Medicare billing, California enrollment
- 3 clinicians in this Medicare group
Alameda, CA 94501
- Reassigned Medicare billing, California enrollment
- 900 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 94015 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
DALY CITY, CA 94015
DALY CITY, CA 94015
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 Connie Tan's NPI number?
The NPI number for Connie Tan is 1679211015. It was assigned to this individual provider in the NPPES registry on May 25, 2022.
Where is Connie Tan located?
Connie Tan practices at 1800 Sullivan Ave Rm 101, Daly City, CA 94015. The listed phone number is (650) 994-0459.
What is Connie Tan's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Connie Tan enrolled in Medicare?
Yes. Connie Tan 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.
Which organizations bill Medicare for Connie Tan's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Connie Tan reassigns Medicare benefits to 2 organizations: Carrillo Medical Group Professional Corporation (Daly City, CA) and Alameda Health System (Alameda, 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 Connie Tan'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 Connie Tan was last updated on May 25, 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.
# Connie Yi Qing Tan, NP · NPI 1679211015
Family physician in Daly City, California. Individual provider, active in the CMS NPPES registry since May 25, 2022.
## Identity
- **NPI:** 1679211015 (Entity type: Individual)
- **Enumerated:** May 25, 2022
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** NP95020349 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 1800 SULLIVAN AVE RM 101, Daly City, CA 94015-2227
- **Phone:** (650) 994-0459
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Carrillo Medical Group Professional Corporation (NPI 1730223421, Daly City, CA); Alameda Health System (NPI 1124446158, Alameda, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2021
## Record status
- **NPPES last updated:** May 25, 2022
---
Source: [NPI Profile](https://npiprofile.com/npi/1679211015) · Data from the CMS NPPES public registry.