Tyna L Queen-Persad, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA030370 Issued in DC

Practice address

1150 Varnum St NE
Washington, DC 20017

Phone

(202) 269-7001

NPI assigned

Jul 4, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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 DC

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tqueenpersad1142688@direct.trinity-health.org
• Direct secure messaging: tyna.queenpersad@maryscenter.eclinicaldirectplus.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.

• Professional Services of Holy Cross

  • Health Service Clinic/Center
  • Silver Spring, MD
  • NPI 1487692828

  DC, Physician Assistant

  Medicare reassignment NPD (past)
• Mary's Center for Maternal and Child Care, Inc

  • Federally Qualified Health Center (FQHC)
  • Washington, DC
  • NPI 1962520288
  Medicare reassignment
• Marys Center for Maternal and Child Care Inc

  • Community/Retail Pharmacy
  • Washington, DC
  • NPI 1831635986
  NPD
• Mary's Center for Maternal and Child Care Inc

  • Federally Qualified Health Center (FQHC)
  • Silver Spring, MD
  • NPI 1174011563
  NPD
• Professional Services of Holy Cross

  dba Holy Cross Health Partners in Rockville

  • Health Service Clinic/Center
  • Rockville, MD
  • NPI 1619787454
  NPD
• Providence Health Services Inc

  • Family Medicine Physician
  • Washington, DC
  • NPI 1669453809
  NPD (past)

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205866241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 VARNUM ST NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20017",
            "telephone_number": "202-269-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 VARNUM ST NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "20017",
            "telephone_number": "202-269-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUEEN-PERSAD",
        "first_name": "TYNA",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DC",
            "license": "PA030370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emena Quattlebaum
• Michelle Quattlebaum
• Alicia Quayson Webb
• Antoinette Quayson
• Guinevere T. Que, NURSE PRACTITIONER
• Aaric Queen, M.D
• Antoine Queen
• Chian Lee Queen
• Daruan Marcellus Queen
• Derrick Lee Queen

• Physician Assistant in Washington, DC
• Providers in Washington, DC by specialty
• Physician Assistant in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.