Anthony F. Tagavilla, M.D.

Primary specialty

Obstetrics PhysicianTaxonomy code 207VX0000X

License

MD00047630 Issued in WA

Practice address

17722 Talbot Rd S
Renton, WA 98055-5744

Phone

(425) 228-0722

Fax

(425) 271-2566

NPI assigned

May 29, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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 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

Specialty

Obstetrics/Gynecology

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kittitas County Public Hospital Dist 1Group PAC ID 0547179608, 82 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kittitas Valley Community Hospital Hospital, Ellensburg, WA, CCN 501333

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Kittitas County Public Hospital Dist 1

  dba Kittitas Valley Community Hospital

  • Critical Access Hospital
  • Ellensburg, WA
  • NPI 1356375307
  Medicare reassignment Care Compare group NPD
• King County Public Hospital District No 2

  dba Booth Gardner Parkinsons Care Center

  • Neuromusculoskeletal Medicine & OMM Physician
  • Kirkland, WA
  • NPI 1801986070
  Medicare reassignment NPD
• Valley Medical Group-Renton

  • General Acute Care Hospital
  • Renton, WA
  • NPI 1619209574
  Medicare reassignment NPD
• King County Public Hospital District No 2

  dba EvergreenHealth Medical Group Pro Fees

  • Internal Medicine Physician
  • Kirkland, WA
  • NPI 1467542639
  NPD
• King County Public Hospital District No. 2

  dba EvergreenHealth at Home Physical Therapy

  • Physical Therapist
  • Kirkland, WA
  • NPI 1356920946
  NPD
• Kittitas County Public Hosp Dist 1

  dba KVH Urology

  • Urology Physician
  • Ellensburg, WA
  • NPI 1437029832
  NPD
• Kittitas County Public Hospital Dist 1

  dba KVH Family Medicine Ellensburg

  • Rural Health Clinic/Center
  • Ellensburg, WA
  • NPI 1770711764
  NPD
• King County Public Hospital District No. 2

  dba EvergreenHealth Medical Center

  • General Acute Care Hospital
  • Kirkland, WA
  • NPI 1033174933
  NPD (past)
• Kittitas County Public Hospital Dist 1

  dba KVH Internal Medicine

  • Rural Health Clinic/Center
  • Ellensburg, WA
  • NPI 1932115391
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Kittitas County Public Hospital Dist 1

  dba Kittitas Valley Community Hospital

  • Critical Access Hospital
  • Ellensburg, WA
  • NPI 1356375307
  Care Compare affiliation

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255532180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17722 TALBOT RD S",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555744",
            "telephone_number": "425-228-0722",
            "fax_number": "425-271-2566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17722 TALBOT RD S",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555744",
            "telephone_number": "425-228-0722",
            "fax_number": "425-271-2566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAGAVILLA",
        "first_name": "ANTHONY",
        "middle_name": "F.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "WA",
            "license": "MD00047630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allen Sy, MD
• Julien T. Ta, PHARMD
• Ngoc-Anh Luu Ta
• Siony F Tabanda, DPD
• Natalie Louise Tadeo Noel
• James Lawrence Taggart, M.D.
• Jon Takagi, PT
• Kenneth K Takemura, M.D.
• Megan Ann Taketa
• Sarah Ashley Taketa, DPT

• Obstetrics Physician in Renton, WA
• Providers in Renton, WA by specialty
• Obstetrics Physician in Washington

• 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.
• 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.