Individual provider Active NPI

Tiffany Yim, PA

  • Surgical Physician Assistant
  • Bellevue, WA
National Provider Identifier
1023174307
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA10005063 Issued in WA
Practice address
1414 116TH Ave NE Ste E
Bellevue, WA 98004-3801
Phone
(425) 753-2918
NPI assigned
Dec 29, 2006
Last updated
Dec 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X PA10005063 WA
Physician Assistant 363A00000X PA10005063 WA
Medical Physician Assistant 363AM0700X PA10005063 WA
Surgical Physician Assistant 363AS0400X PA10005063 WA Primary

Addresses

Primary practice location

1414 116TH Ave NE Ste E
Bellevue, WA 98004-3801

Mailing address

3040 78TH Ave SE Unit 958
Mercer Island, WA 98040-3685
Phone (650) 302-2624

Other practice location 1

1100 9th Ave
Seattle, WA 98101-2756
Phone (206) 223-6600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20070613000502 WA Practitioner - Physician Assistant 3375641442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Arts PLLCGroup PAC ID 5597985317, 7 clinicians

Practice addresses (Care Compare)

1414 116TH Ave NE
Suite E
Bellevue, WA 98004-3801
Phone (425) 753-2918

Merit-based Incentive Payment System (MIPS)

Final score
54.48 of 100Reported as group
Quality
71.77
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA10005063WAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Whidbey General Surgery Current Accepting new patients
Cardiothoracic Surgery Associates PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tiffany.yim@direct.vmmc.org
  • Direct secure messaging: tiffany@dermarts.emadirect.md

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1023174307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3040 78TH AVE SE UNIT 958",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980403685",
            "telephone_number": "650-302-2624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 116TH AVE NE STE E",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043801",
            "telephone_number": "425-753-2918"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 9th Ave",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981012756",
            "country_code": "US",
            "telephone_number": "206-223-6600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YIM",
        "first_name": "TIFFANY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "PA10005063",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10005063",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10005063",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA10005063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.