Jonah O Tan, MPT, PA-C is a medicare enrolled "Physician Assistant" provider in Simi Valley, California. He graduated from medical school in 2003 and has 23 years of diverse experience with area of expertise as Physical Therapist In Private Practice. He is a member of the group practice Southern California Permanente Medical Group and his current practice location is
3200 E Los Angeles Ave, Suite 20, Simi Valley, California. You can reach out to his office (for appointments etc.) via phone at
(805) 581-4266.
Jonah O Tan is licensed to practice in California (license number PA16970) and he also participates in the medicare program. He
may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1477569010.
Healthcare Provider's Profile
| Full Name | Jonah O Tan |
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| Gender | Male |
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| Speciality | Physical Therapist In Private Practice |
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| Experience | 23 Years |
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| Location | 3200 E Los Angeles Ave, Simi Valley, California |
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| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Jonah O Tan graduated from medical school in 2003
NPI Data:
- NPI Number: 1477569010
- Provider Enumeration Date: 08/01/2006
- Last Update Date: 06/24/2026
Medicare PECOS Information:
- PECOS PAC ID: 2264324599
- Enrollment ID: I20110902000365
Medical Identifiers
Medical identifiers for Jonah O Tan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1477569010 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2251X0800X | Physical Therapist - Orthopedic | PT24912 (California) | Secondary |
| 363A00000X | Physician Assistant | PA16970 (California) | Primary |
Medical Facilities Affiliation
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. Jonah O Tan allows following entities to bill medicare on his behalf.
| Provider Name | Divine Health Provider Physical Therapy Inc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1386899763
PECOS PAC ID: 6103980651
Enrollment ID: O20090127000680 |
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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. Jonah O 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 |
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Jonah O Tan, MPT, PA-C
1687 Erringer Rd, Ste 109,
Simi Valley, CA 93065-6508
Ph: (805) 581-4266 | Jonah O Tan, MPT, PA-C
3200 E Los Angeles Ave, Suite 20,
Simi Valley, CA 93065-3972
Ph: (805) 581-4266 |
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