Individual provider Active NPI

Tiffany Ann Rose, PA-C

  • Physician Assistant
  • Waco, TX
National Provider Identifier
1003298050
Registry record updated Dec 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA09855 Issued in TX
Practice address
120 Hillcrest Medical Blvd Ste 200
Waco, TX 76712-8950
Phone
(254) 297-0400
NPI assigned
Jun 26, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA09855 TX Primary

Addresses

Primary practice location

120 Hillcrest Medical Blvd Ste 200
Waco, TX 76712-8950

Mailing address

PO Box 844658
Dallas, TX 75284-4658

Other names 1

  • Tiffany Ann Mason Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address trose73914@direct.sw.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160525000423 TX Practitioner - Physician Assistant 8628367059 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

120 Hillcrest Medical Blvd
Waco, TX 76712-8948
Phone (254) 202-9950

120 Hillcrest Medical Blvd
Suite 200
Waco, TX 76712-8950
Phone (254) 297-0400

1605 S 31St St
Baylor Scott and White Center for Dia
Temple, TX 76508-0001
Phone (254) 215-0100

2401 S 31 St
Temple, TX 76508-0001
Phone (254) 724-2459

2401 S 31St St BLDG
35 Baylor Scott and White Roney Bone and
Temple, TX 76508-0001
Phone (254) 724-2663

810 W U Ave
Temple, TX 76508-0001
Phone (254) 724-2585

Hospital & facility affiliations

  • Baylor Scott & White Medical Center - Temple Hospital, Temple, TX, CCN 450054
  • Baylor Scott & White Medical Center Hillcrest Hospital, Waco, TX, CCN 450101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Hospital - Taylor Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1435276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640217600000",
    "number": "1003298050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 HILLCREST MEDICAL BLVD STE 200",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767128950",
            "telephone_number": "254-297-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "TIFFANY",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-26",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA09855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "trose73914@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "120 Hillcrest Medical Blvd Ste 200",
            "city": "Waco",
            "state": "TX",
            "country_code": "US",
            "postal_code": "767128950",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "MASON",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.