Active NPI
Tiffany Michelle Perraut, NP
- Neonatal Nurse Practitioner
- Seattle, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal Nurse Practitioner
- License
- AP61309304
- Practice address
- 1550 N 115TH St
Seattle, WA 98133-8401 - Phone
- (206) 520-5000
- NPI assigned
- Nov 1, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal Nurse Practitioner | 363LN0000X | 71009035A | IN | |
| Neonatal Nurse Practitioner | 363LN0000X | 2014042988 | MO | |
| Neonatal Nurse Practitioner | 363LN0000X | AP61309304 | WA | Primary |
Addresses
Primary practice location
1550 N 115TH St
Seattle, WA 98133-8401
Mailing address
PO Box 50095
Seattle, WA 98145-5095
Phone (206) 520-5700
Other practice location 1
2401 W University Ave
Muncie, IN 47303-3428
Phone (765) 751-2650
Other practice location 2
1 Childrens Pl
Saint Louis, MO 63110-1002
Phone (859) 533-4872
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306358171 | Medicaid | WA |
Other names 1
- Tiffany Michelle Hicks
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tperraut@direct.iuhealth.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2014042988 | MO | MD | Neonatal Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iu Health Medical Group, LLC | Current | Accepting new patients |
Locations
250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174
1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754
2401 W University Ave
Muncie, IN 47303
Phone (765) 747-3111
221 N Celia Ave
Muncie, IN 47303
Phone (765) 747-3141
1200 W White River Blvd
Muncie, IN 47303
Phone (765) 254-4009
Organizations & group practices 2
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.
-
- General Practice Physician
- Indianapolis, IN
- NPI 1326893777
-
- Family Medicine Physician
- Muncie, IN
- NPI 1235455544
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1509494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731369600000",
"number": "1306358171",
"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": "1550 N 115TH ST",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981338401",
"telephone_number": "206-520-5000"
}
],
"practiceLocations": [
{
"address_1": "2401 W University Ave",
"address_purpose": "LOCATION",
"city": "Muncie",
"state": "IN",
"postal_code": "473033428",
"country_code": "US",
"telephone_number": "765-751-2650",
"fax_number": "765-751-2629",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1 Childrens Pl",
"address_purpose": "LOCATION",
"city": "Saint Louis",
"state": "MO",
"postal_code": "631101002",
"country_code": "US",
"telephone_number": "859-533-4872",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PERRAUT",
"first_name": "TIFFANY",
"middle_name": "MICHELLE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-01",
"last_updated": "2024-11-12",
"certification_date": "2024-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LN0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal",
"state": "IN",
"license": "71009035A",
"primary": false
},
{
"code": "363LN0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal",
"state": "MO",
"license": "2014042988",
"primary": false
},
{
"code": "363LN0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal",
"state": "WA",
"license": "AP61309304",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1306358171",
"state": "WA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tperraut@direct.iuhealth.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "2401 W University Ave",
"city": "Muncie",
"state": "IN",
"country_code": "US",
"postal_code": "473033428",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "TIFFANY",
"last_name": "HICKS",
"middle_name": "MICHELLE",
"credential": "ARNP",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.