Timothy Ahn, NP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

AP61193179 Issued in WA

Practice address

1515 116TH Ave NE Ste 104
Bellevue, WA 98004-3811

Phone

(425) 247-3362

NPI assigned

Jul 9, 2021

Last updated

Sep 14, 2026By the provider in NPPES

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Legacy Clinics LLC

  • Clinic/Center
  • Portland, OR
  • NPI 1902827272

  WA

  Medicare reassignment NPD
• Timberly's Pediatric and Adolescent Care PLLC

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

  dba Legacy Medical Group Firwood

  • 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": "1789344000000",
    "number": "1154992121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 116TH AVE NE STE 104",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043811",
            "telephone_number": "425-247-3362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 116TH AVE NE STE 104",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043811",
            "telephone_number": "425-247-3362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHN",
        "first_name": "TIMOTHY",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-09",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "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
• Aitm LLC
• Karen Akasaka, DO
• Olubukayo Akinyemi

• 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 Sep 14, 2026; 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.