Jessica Suhui Tan, MD is a medicare enrolled "Allergy & Immunology" physician in San Mateo, California. Her current practice location is
1000 Franklin Pkwy, San Mateo, California. You can reach out to her office (for appointments etc.) via phone at
(650) 299-2485.
Jessica Suhui Tan is licensed to practice in California (license number A115558) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1578713707.
Physician's Profile
| Full Name | Jessica Suhui Tan |
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| Gender | Female |
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| Speciality | Allergy & Immunology |
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| Location | 1000 Franklin Pkwy, San Mateo, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1578713707
- Provider Enumeration Date: 09/24/2008
- Last Update Date: 01/24/2022
Medicare PECOS Information:
- PECOS PAC ID: 8224211693
- Enrollment ID: I20160126002568
Medical Identifiers
Medical identifiers for Jessica Suhui Tan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1578713707 | NPI | - | NPPES |
| 3130203 | Medicaid | OH | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207R00000X | Internal Medicine | A115558 (California) | Secondary |
| 207R00000X | Internal Medicine | 16139 (Hawaii) | Secondary |
| 207R00000X | Internal Medicine | 35096723 (Ohio) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | 57-014949 (Ohio) | Secondary |
| 207K00000X | Allergy & Immunology | A115558 (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jessica Suhui Tan allows following entities to bill medicare on her behalf.
| Entity Name | Permanente Medical Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1073606299
PECOS PAC ID: 8921910225
Enrollment ID: O20031104000710 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jessica Suhui Tan is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jessica Suhui Tan, MD
1000 Franklin Pkwy,
San Mateo, CA 94403-1922
Ph: (650) 299-2181 | Jessica Suhui Tan, MD
1000 Franklin Pkwy,
San Mateo, CA 94403-1922
Ph: (650) 299-2485 |
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