Lancy Mimi Tan, MD - Medicare Surgery in Shoreline, WA

Lancy Mimi Tan, MD is a medicare enrolled "Surgery" physician in Shoreline, Washington. Her current practice location is 19930 Ballinger Way Ne, Shoreline, Washington. You can reach out to her office (for appointments etc.) via phone at (425) 778-2220.

Lancy Mimi Tan is licensed to practice in Washington (license number MD61170965) 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 1073044301.

Contact Information

Lancy Mimi Tan, MD
19930 Ballinger Way Ne,
Shoreline, WA 98155-1223
(425) 778-2220
(425) 778-7701



Physician's Profile

Full NameLancy Mimi Tan
GenderFemale
SpecialitySurgery
Location19930 Ballinger Way Ne, Shoreline, Washington
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1073044301
  • Provider Enumeration Date: 03/27/2017
  • Last Update Date: 04/05/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 4789955220
  • Enrollment ID: I20220707001800

Medical Identifiers

Medical identifiers for Lancy Mimi Tan such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1073044301NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208600000XSurgery MD210187 (Oregon)Secondary
208600000XSurgery MD61170965 (Washington)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. Lancy Mimi Tan allows following entities to bill medicare on her behalf.
Entity NameLegacy Good Samaritan Hospital And Medical Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1780608216
PECOS PAC ID: 0547179939
Enrollment ID: O20031125000416

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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. Lancy Mimi 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 AddressPractice Location Address
Lancy Mimi Tan, MD
19930 Ballinger Way Ne,
Shoreline, WA 98155-1223

Ph: (425) 778-2220
Lancy Mimi Tan, MD
19930 Ballinger Way Ne,
Shoreline, WA 98155-1223

Ph: (425) 778-2220

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Surgery Doctors in Shoreline, WA

Dr. Jedediah A Kaufman, MD
Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 19930 Ballinger Way Ne, Shoreline, WA 98155
Phone: 425-778-2220    
Dr. Sigrid Pakula Guyton, M.D.
Surgery
Medicare: Not Enrolled in Medicare
Practice Location: 111 Nw Highland Dr, The Highlands, 111, Shoreline, WA 98177
Phone: 206-365-1479    
Alvina Won, MD
Surgery
Medicare: Not Enrolled in Medicare
Practice Location: 19930 Ballinger Way Ne, Shoreline, WA 98155
Phone: 425-778-2220    
Brandon Willem Vanderwel, M.D.
Surgery
Medicare: Not Enrolled in Medicare
Practice Location: 19930 Ballinger Way Ne, Shoreline, WA 98155
Phone: 425-778-2220    
Dr. Kurtis Alan Stewart, MD
Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 19930 Ballinger Way Ne, Shoreline, WA 98155
Phone: 425-778-2220    
Robert W Landerholm, MD
Surgery
Medicare: Not Enrolled in Medicare
Practice Location: 19930 Ballinger Way Ne, Shoreline, WA 98155
Phone: 425-778-2220    

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