Timothy Jay Mollotte, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.PA.61363297 Issued in WA

Practice address

358 N Main St
Colville, WA 99114-2310

Phone

(509) 684-1440

NPI assigned

Aug 31, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: timothy.mollotte.1@18424.direct.athenahealth.com

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.

• New Health Programs Association

  dba NEW Health Chewelah Medical

  • Federally Qualified Health Center (FQHC)
  • Chewelah, WA
  • NPI 1679537575
  Medicare reassignment
• New Health Programs Association

  dba NEW Health Newport Medical

  • Federally Qualified Health Center (FQHC)
  • Newport, WA
  • NPI 1407530157
  NPD

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

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1073281572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 808",
            "city": "CHEWELAH",
            "state": "WA",
            "postal_code": "991090808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "358 N MAIN ST",
            "city": "COLVILLE",
            "state": "WA",
            "postal_code": "991142310",
            "telephone_number": "509-684-1440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4311 11th Ave NE Ste 200",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981056367",
            "country_code": "US",
            "telephone_number": "206-616-4001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOLLOTTE",
        "first_name": "TIMOTHY",
        "middle_name": "JAY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-31",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA.PA.61363297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan J Miller
• Brooklyn Nicole Mills
• Davida C Mills, RC
• Elizabeth Mings
• Evelyn Mire
• Deborah A Montowski, MD
• Monumental Health and Wellness PLLC
• Monumental Health and Wellness PLLC (MONUMENTAL Health & Wellness LLC)
• Amanda Marie Moore
• Darby A Moore

• Physician Assistant in Colville, WA
• Providers in Colville, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.