Tiffany-Polynne T Yang, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

200 Carmichael Way Ste 606
Chesapeake, VA 23322-2489

Phone

(757) 401-4163

Fax

(757) 908-2065

NPI assigned

Mar 31, 2022

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 names 1

• Tiffany Stapornkul Former name

Medicare fee-for-service enrollment

Enrolled in VA

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

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

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.

• Tidewater Physicians Multispecialty Group PC

  • Family Medicine Physician
  • Newport News, VA
  • NPI 1902848294
  Medicare reassignment NPD
• Tidewater Physicians Multispecialty Group PC

  • Ambulatory Surgical Clinic/Center
  • Williamsburg, VA
  • NPI 1316790512
  NPD
• Tidewater Physicians Multispecialty Group PC

  • Professional Counselor
  • Newport News, VA
  • NPI 1326428129
  NPD (past)
• Trusted Doctors LLC

  • Pediatrics Physician
  • Fairfax, VA
  • NPI 1083793525
  NPD (past)

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

{
    "created_epoch": "1648684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655769600000",
    "number": "1376283960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CARMICHAEL WAY STE 606",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233222489",
            "telephone_number": "757-401-4163",
            "fax_number": "757-908-2065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CARMICHAEL WAY STE 606",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233222489",
            "telephone_number": "757-401-4163",
            "fax_number": "757-908-2065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANG",
        "first_name": "TIFFANY-POLYNNE",
        "middle_name": "T",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-31",
        "last_updated": "2022-06-21",
        "certification_date": "2022-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "STAPORNKUL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Franklin Yambao, PHARMD
• Yameika Surgical Group, P.C.
• Jieming Yan, MD
• Tesha Yancey, MSW
• Yvette Michelle Yancey
• Kristin Yannessa
• David Yasemsky, LPC
• Meagan Yauilla, FNP
• Keisha Yearwood
• Sheri L Yeatts, PA-C

• Physician Assistant in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2022; 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.