Individual provider Active NPI

Bismark R Fernandez Tavarez, M.D.

  • Internal Medicine Physician
  • Yakima, WA
National Provider Identifier
1124375225
Registry record updated Sep 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
29799R Issued in PR
Practice address
2811 Tieton Dr
Yakima, WA 98902
Phone
(509) 833-5592
NPI assigned
Aug 7, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 29799R PR Primary

Addresses

Primary practice location

2811 Tieton Dr
Yakima, WA 98902

Mailing address

2811 Tieton Dr
Yakima, WA 98902
Phone (509) 833-5592

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160624000831 WA Practitioner - Internal Medicine 4981995719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yakima Valley Memorial PhysiciansGroup PAC ID 1557391596, 397 clinicians

Practice addresses (Care Compare)

2811 Tieton Dr
Yakima, WA 98902-3761
Phone (509) 575-8000

Hospital & facility affiliations

  • Yakima Valley Memorial Hospital, Yakima, WA, CCN 500036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
29799RPRMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yakima Valley Memorial Physicians CurrentSince Jul 11, 2016 Accepting new patients
Yakima Valley Memorial Physicians CurrentSince Jul 11, 2016 Accepting new patients
Yakima Valley Memorial Hospital Association Past Accepting new patients

Locations

2811 Tieton Dr
Yakima, WA 98902
Phone (509) 249-5210

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/ef853cc1-94e4-4ed7-883a-9be7485e458e/

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1344297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473811200000",
    "number": "1124375225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2811 TIETON DR",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "98902",
            "telephone_number": "509-833-5592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 TIETON DR",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "98902",
            "telephone_number": "509-833-5592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ TAVAREZ",
        "first_name": "BISMARK",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-07",
        "last_updated": "2016-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "29799R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.