Jonah O Tan, MPT, PA-C is a medicare enrolled "Physical Therapist - Orthopedic" in Simi Valley, California. He graduated from nursing school in 2003 and has 21 years of diverse experience with area of expertise as Physical Therapy. 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 PT24912) 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.
Provider's Profile
| Full Name | Jonah O Tan |
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| Gender | Male |
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| Speciality | Physical Therapy |
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| Experience | 21 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 nursing school in 2003
NPI Data:
- NPI Number: 1477569010
- Provider Enumeration Date: 08/01/2006
- Last Update Date: 11/30/2021
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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| 363A00000X | Physician Assistant | PA16970 (California) | Secondary |
| 2251X0800X | Physical Therapist - Orthopedic | PT24912 (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. Jonah O Tan allows following entities to bill medicare on his behalf.
| Entity Name | Divine Health Provider Physical Therapy Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity 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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