Shie-Pon Tzung, MD PHD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

31810 Issued in WA

Practice address

1135 116TH Ave NE
#560
Bellevue, WA 98004

Phone

(425) 454-4768

Fax

(425) 462-8021

NPI assigned

Jan 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WA, MT2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Gastroenterology

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Grant County Public Hospital District 1Group PAC ID 9931095692, shared by 3 NPIs, 112 clinicians

Kaiser Foundation Health Plan of WashingtonGroup PAC ID 9032022579, 1,519 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stzung4287077@ghc.direct-ci.net

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.

• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701
  Medicare reassignment Care Compare group NPD
• Grant County Public Hospital District 1

  • Rural Health Clinic/Center
  • Moses Lake, WA
  • NPI 1619086766
  Medicare reassignment NPD
• Benefis Hospitals Inc

  • Multi-Specialty Clinic/Center
  • Great Falls, MT
  • NPI 1780968974
  Medicare reassignment NPD
• St Peter'S Health

  • General Acute Care Hospital
  • Helena, MT
  • NPI 1205025145
  Medicare reassignment NPD
• Grant County Public Hospital District 1

  • Rural Health Clinic/Center
  • Moses Lake, WA
  • NPI 1609112739
  NPD
• Grant County Public Hospital District 1

  • General Acute Care Hospital
  • Moses Lake, WA
  • NPI 1902818883
  NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1386935351
  NPD
• St. Peter'S Health

  • Family Medicine Physician
  • Townsend, MT
  • NPI 1174165682
  NPD
• St. Peter'S Health

  • Radiology Clinic/Center
  • Butte, MT
  • NPI 1194785154
  NPD
• Benefis Hospitals, Inc.

  • Physical Therapist
  • Great Falls, MT
  • NPI 1750530515
  NPD (past)

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

{
    "created_epoch": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1023096252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 116TH AVE NE",
            "address_2": "#560",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98004",
            "telephone_number": "425-454-4768",
            "fax_number": "425-462-8021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 116TH AVE NE",
            "address_2": "#560",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98004",
            "telephone_number": "425-454-4768",
            "fax_number": "425-462-8021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1101 26th St S",
            "address_purpose": "LOCATION",
            "city": "Great Falls",
            "state": "MT",
            "postal_code": "594055161",
            "country_code": "US",
            "telephone_number": "406-731-8888",
            "fax_number": "406-731-8318",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 16th Ave E",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981125226",
            "country_code": "US",
            "telephone_number": "206-326-3000",
            "fax_number": "877-515-2975",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TZUNG",
        "first_name": "SHIE-PON",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-06",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MT",
            "license": "99746",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WA",
            "license": "31810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "145887",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8218612",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "201 16th Ave E",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981125226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rosemary Bannon Tyksinski, MA, LMHC, PHD, BCC
• Donelle J Tyler, M.ED.
• Scott E Tyler, MD
• Emily Tyra
• Phyllis Tyson, PH.D.
• Augusta Szeto U
• U.S. Healthworks Medical Group of Washington, PS
• Rachael Marie Uberstine, ARNP
• Ubretail.L.L.C
• Elienhel Joy G Udtohan, LP61213828

• Gastroenterology Physician in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Gastroenterology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.