Individual provider Active NPI

Tiffany Elizabeth Gallucci, NP-C

  • Adult Health Nurse Practitioner
  • Tacoma, WA
National Provider Identifier
1164990396
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP6168859 Issued in WA
Practice address
209 Martin Luther King Jr Way
Tacoma, WA 98405-4267
Phone
(253) 596-3300
Fax
(253) 383-6106
NPI assigned
Nov 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 3012589 KY
Adult Health Nurse Practitioner 363LA2200X AP6168859 WA Primary

Addresses

Primary practice location

209 Martin Luther King Jr Way
Tacoma, WA 98405-4267

Mailing address

209 Martin Luther King Jr Way
Tacoma, WA 98405-4267
Phone (253) 596-3300

Other practice location 1

4915 Norton Healthcare Boulevard
Louisville, KS 40241
Phone (502) 629-1234

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, NY, WA3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20190125003151 KY Practitioner - Nurse Practitioner 1759628985 Reassigns benefits to 2 organizations
I20240425000160 NY Practitioner - Nurse Practitioner 1759628985 Reassigns benefits to 1 organization
I20250905003250 WA Practitioner - Nurse Practitioner 1759628985 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of WashingtonGroup PAC ID 9032022579, 1,519 clinicians

Practice addresses (Care Compare)

209 Martin Luther King Jr Way
Tacoma, WA 98405-4265
Phone (253) 596-3300

Merit-based Incentive Payment System (MIPS)

Final score
79.07 of 100Reported as group
Quality
57.91
Promoting interoperability
77
Improvement activities
40
Cost
80.36

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3012589KYMDAdult Health Nurse Practitioner
AP6168859WAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince Aug 5, 2025 Accepting new patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients
Norton Hospitals, Inc CurrentSince Aug 25, 2019 Accepting new patients
Community Medical Associates, Inc. CurrentSince Dec 17, 2018 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Aug 5, 2025 Accepting new patients
Norton Hospitals Inc CurrentSince Aug 25, 2019 Accepting new patients
North Shore Health System Medical Faculty Group Practice Inc CurrentSince Mar 25, 2024 Accepting new patients
Community Medical Associates, Inc. CurrentSince Dec 17, 2018 Accepting new patients
Community Medical Associates, Inc. Adult Health Current Accepting new patients

Locations

315 E Broadway
Fl 4
Louisville, KY 40202
Phone (502) 272-5165

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

4915 Norton Healthcare Blvd
Louisville, KY 40241
Phone (502) 446-6611

315 E Broadway
Louisville, KY 40202
Phone (502) 272-5331

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

450 Lakeville Rd
North New Hyde Park, NY 11042
Phone (516) 321-3000

27005 76th Ave
North New Hyde Pk, NY 11040

9525 Queens Blvd
Ste B
Rego Park, NY 11374
Phone (718) 925-6200

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

209 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 596-3300

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: tgallucci152169@direct.nortonhealthcare.org

Organizations & group practices 9

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": "1541462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1164990396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 MARTIN LUTHER KING JR WAY",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054267",
            "telephone_number": "253-596-3300",
            "fax_number": "253-383-6106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 MARTIN LUTHER KING JR WAY",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054267",
            "telephone_number": "253-596-3300",
            "fax_number": "253-383-6106"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4915 Norton Healthcare Boulevard",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KS",
            "postal_code": "40241",
            "country_code": "US",
            "telephone_number": "502-629-1234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GALLUCCI",
        "first_name": "TIFFANY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-06",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "KY",
            "license": "3012589",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WA",
            "license": "AP6168859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "209 Martin Luther King Jr Way",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984054267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.