Individual provider Active NPI

Tiffany Michelle Perraut, NP

  • Neonatal Nurse Practitioner
  • Seattle, WA
National Provider Identifier
1306358171
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
AP61309304 Issued in WA
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

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1306358171MedicaidWA

Other names 1

  • Tiffany Michelle Hicks Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190806001938 IN Practitioner - Nurse Practitioner 0446587000 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2014042988MOMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Iu Health Medical Group, LLC CurrentSince Oct 1, 2025 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.

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

Verify at the official NPI Registry.