Heidi A Tate, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA60107657 Issued in WA

Practice address

24360 Van Ry Blvd Ste 111
Mountlake Terrace, WA 98043-5457

Phone

(206) 520-5000

NPI assigned

Nov 19, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

93.85 of 100Reported as apm

Quality

74.6

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

90.65 of 100Reported as group

Promoting interoperability

89

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1258588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1245568864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095",
            "telephone_number": "206-520-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24360 VAN RY BLVD STE 111",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980435457",
            "telephone_number": "206-520-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATE",
        "first_name": "HEIDI",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-19",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA170945",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60107657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PA170945",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PA60107657",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• The Camelot Society (Camelot Society)
• The Camelot Society (Camelot Society)

• Physician Assistant in Mountlake Terrace, WA
• Providers in Mountlake Terrace, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.