Individual provider Active NPI

Tanya I Bryant, M.D.

  • Family Medicine Physician
  • Lynnwood, WA
National Provider Identifier
1194739987
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00044245 Issued in WA
Practice address
6101 200TH St SW
Ste 208
Lynnwood, WA 98036-6077
Phone
(425) 775-2066
Fax
(425) 775-5306
NPI assigned
Jul 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00044245 WA Primary

Addresses

Primary practice location

6101 200TH St SW
Ste 208
Lynnwood, WA 98036-6077

Mailing address

6101 200TH St SW
Ste 208
Lynnwood, WA 98036-6077
Phone (425) 775-2066

Other identifiers 2

IdentifierTypeStateIssuer
8431090MedicaidWA
0199256OtherWAL & I

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
I20050908001242 WA Practitioner - Family Practice 8729010863 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6101 200TH St SW
Suite 208
Lynnwood, WA 98036-6077
Phone (425) 775-2066

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00044245WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edmonds Family Care, PLLC CurrentSince Apr 25, 2005 Accepting new patients

Locations

21906 76th Ave W
Edmonds, WA 98026
Phone (425) 577-4262

6101 200th St SW
Ste 208
Lynnwood, WA 98036
Phone (425) 775-2066

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AIGCAA/Endpoint/AIGCAA

Organizations & group practices 1

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 2

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1194739987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 200TH ST SW",
            "address_2": "STE 208",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980366077",
            "telephone_number": "425-775-2066",
            "fax_number": "425-775-5306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 200TH ST SW",
            "address_2": "STE 208",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980366077",
            "telephone_number": "425-775-2066",
            "fax_number": "425-775-5306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "TANYA",
        "middle_name": "I",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00044245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8431090",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "0199256",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

Verify at the official NPI Registry.