KELAN G. TANTISIRA MD MPH
NPI 1760420434
Internal Medicine - Pulmonary Disease in San Diego, CA
About Kelan G. Tantisira Md Mph NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELAN G. TANTISIRA MD MPH (NPI 1760420434) is an individual pulmonary disease provider in San Diego, California, licensed in California (G67143) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Kelan G. Tantisira Md Mph is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Kelan Tantisira reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
San Diego, CA 92123
- Reassigned Medicare billing, California enrollment
- 562 clinicians in this Medicare group
Boston, MA 02115
- Reassigned Medicare billing, Massachusetts enrollment
- 4,574 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 92123 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 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAN DIEGO, CA 92123
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 Kelan Tantisira's NPI number?
The NPI number for Kelan Tantisira is 1760420434. It was assigned to this individual provider in the NPPES registry on June 3, 2006.
Where is Kelan Tantisira located?
Kelan Tantisira practices at 3030 Childrens Way, San Diego, CA 92123. The listed phone number is (858) 966-5846.
What is Kelan Tantisira's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.
Is Kelan Tantisira enrolled in Medicare?
Yes. Kelan Tantisira is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Kelan Tantisira's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelan Tantisira reassigns Medicare benefits to 2 organizations: Rady Children's Hospital San Diego (San Diego, CA) and Brigham & Womens Physicians Organization Inc (Boston, MA). 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 Kelan Tantisira'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 Kelan Tantisira was last updated on January 7, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Kelan G. Tantisira, MD MPH · NPI 1760420434
Pulmonary Disease physician in San Diego, California. Individual provider, active in the CMS NPPES registry since June 3, 2006.
## Identity
- **NPI:** 1760420434 (Entity type: Individual)
- **Enumerated:** June 3, 2006
- **Primary specialty:** Internal Medicine - Pulmonary Disease · taxonomy 207RP1001X
- **State license:** G67143 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 3030 CHILDRENS WAY, San Diego, CA 92123-4232
- **Phone:** (858) 966-5846
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **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): Rady Children's Hospital San Diego (NPI 1669617197, San Diego, CA); Brigham & Womens Physicians Organization Inc (NPI 1033535497, Boston, MA) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 7, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1760420434) · Data from the CMS NPPES public registry.