Timothy Ahn, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

AP61193179 Issued in WA

Practice address

15620 NE 21St St
Bellevue, WA 98008

Phone

(206) 210-8480

NPI assigned

Jul 9, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, OR2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: timothy.ahn.1@30819.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.

• Legacy Clinics LLC

  • Clinic/Center
  • Portland, OR
  • NPI 1902827272

  WA

  Medicare reassignment NPD
• Timberly'S Pediatric and Adolescent Care LLC

  • Pediatrics Physician
  • Seattle, WA
  • NPI 1942079587
  NPD (past) Authorized official
• Legacy Clinics LLC

  • Rural Health Clinic/Center
  • Sandy, OR
  • NPI 1730472192
  NPD

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

{
    "created_epoch": "1625788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674518400000",
    "number": "1154992121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4730 UNIVERSITY WAY NE STE 104",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981054424",
            "telephone_number": "206-210-8480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15620 NE 21ST ST",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98008",
            "telephone_number": "206-210-8480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHN",
        "first_name": "TIMOTHY",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-09",
        "last_updated": "2023-01-24",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WA",
            "license": "AP61193179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nur Farhanah Binti Ahmad Faizal
• Mahwish Khan Ahmad
• Mandana Ahmadian, MD
• Fatuma Ahmed
• Tariq Ahmed, M.D., M.P.H.
• Nadia Giuliano Ahrens, LICSW
• Amanda Mele Ahsoon
• Karen Akasaka, DO
• Olubukayo Akinyemi
• Akira Nakada, DMD, PLLC

• Pediatric Nurse Practitioner in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Pediatric Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; 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.