Individual provider Active NPI

Jeffrey S Feen, PA

  • Physician Assistant
  • Yakima, WA
National Provider Identifier
1023564705
Registry record updated Nov 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 60672199 Issued in WA
Practice address
1806 W Lincoln Ave
Yakima, WA 98902-2473
Phone
(509) 452-4520
Fax
(509) 452-5224
NPI assigned
Aug 31, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2016

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 PA 60672199 WA Primary

Addresses

Primary practice location

1806 W Lincoln Ave
Yakima, WA 98902-2473

Mailing address

501 S 5TH Ave
Yakima, WA 98902-3550
Phone (509) 494-6700

Other identifiers 1

IdentifierTypeStateIssuer
2070618MedicaidWA

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
I20161214002571 WA Practitioner - Physician Assistant 4385924026 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA 60672199WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sunnyside Community Hospital Association CurrentSince Jan 1, 2018 Accepting new patients
Sunnyside Community Hospital Association CurrentSince Jan 1, 2018 Accepting new patients
Pinnacle Health Care PLLC Past Accepting new patients

Locations

208 N Euclid Rd
Grandview, WA 98930
Phone (509) 882-1855

2925 Allen Rd
Sunnyside, WA 98944
Phone (509) 837-4949

502 W 4th Ave
Toppenish, WA 98948
Phone (509) 575-5000

6201 Summitview Ave
Ste 106
Yakima, WA 98908
Phone (509) 248-0497

Interoperability endpoints

  • Direct secure messaging: jeffrey.feen.1@4690.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1023564705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S 5TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023550",
            "telephone_number": "509-494-6700",
            "fax_number": "509-573-6275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 W LINCOLN AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989022473",
            "telephone_number": "509-452-4520",
            "fax_number": "509-452-5224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEEN",
        "first_name": "JEFFREY",
        "middle_name": "S",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-31",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA 60672199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2070618",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.