Individual provider Active NPI

Mahlet Tamrat, PAC

  • Physician Assistant
  • Seattle, WA
National Provider Identifier
1104280940
Registry record updated Nov 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60731572 Issued in WA
Practice address
600 Broadway
Seattle, WA 98122-5229
Phone
(206) 302-2600
NPI assigned
Apr 7, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2877 TN
Physician Assistant 363A00000X PA60731572 WA Primary

Addresses

Primary practice location

600 Broadway
Seattle, WA 98122-5229

Mailing address

6400 Southcenter Blvd
Tukwila, WA 98188-2547
Phone (206) 901-2000

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
I20170323001375 WA Practitioner - Physician Assistant 4587949037 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Fandm Healthcare, LLCGroup PAC ID 8628462983, 30 clinicians
SoundGroup PAC ID 1759282197, 50 clinicians

Practice addresses (Care Compare)

Tacoma, WA 98406
Phone (253) 777-1423

1600 E Olive St
Seattle, WA 98122-2735
Phone (206) 302-2200

6400 Southcenter Blvd
Tukwila, WA 98188-2547
Phone (206) 901-2000

National Provider Directory

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1459987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1104280940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 SOUTHCENTER BLVD",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981882547",
            "telephone_number": "206-901-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 BROADWAY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225229",
            "telephone_number": "206-302-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAMRAT",
        "first_name": "MAHLET",
        "credential": "PAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-07",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TN",
            "license": "2877",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60731572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.