Tyrell P Nielson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1269 Issued in ID

Practice address

2935 Allen Rd
Sunnyside, WA 98944-8931

Phone

(509) 837-0070

Fax

(509) 837-0690

NPI assigned

Aug 16, 2010

Last updated

Dec 3, 2020By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA, ID2 enrollments

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 2

Merit-based Incentive Payment System (MIPS)

Final score

83.73 of 100Reported as group

Quality

80.23

Promoting interoperability

82

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Derek S Weaver DO PLLC

  dba Weaver Family Medicine

  • Family Medicine Physician
  • Sunnyside, WA
  • NPI 1982081485
  Medicare reassignment
• Prosser Public Hospital District of Benton County

  dba Prosser Memorial Health

  • Critical Access Hospital
  • Prosser, WA
  • NPI 1306897681
  Medicare reassignment
• Physicians Immediate Care of Twin Falls PA

  dba Physicians Immediate Care Center

  • Urgent Care Clinic/Center
  • Twin Falls, ID
  • NPI 1114141090
  Medicare reassignment
• Prosser Public Hospital District of Benton County

  dba Prosser Memorial Hospital Swing CAH

  • Critical Access Hospital
  • Prosser, WA
  • NPI 1013956259
  NPD
• Prosser Public Hospital District of Benton County

  dba Prosser Memorial Health Spine Clinic

  • Specialist
  • Walla Walla, WA
  • NPI 1518770155
  NPD
• Prosser Public Hospital District of Benton County

  dba Prosser Memorial Health - Sunnyside Clinic

  • Rural Health Clinic/Center
  • Sunnyside, WA
  • NPI 1558271122
  NPD (past)
• Page Family Medicine

  • Family Medicine Physician
  • Burley, ID
  • NPI 1487151882
  NPD (past)

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

{
    "created_epoch": "1281916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1376858209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2935 ALLEN RD",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989448931",
            "telephone_number": "509-837-0070",
            "fax_number": "509-837-0690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2935 ALLEN RD",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989448931",
            "telephone_number": "509-837-0070",
            "fax_number": "509-837-0690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSON",
        "first_name": "TYRELL",
        "middle_name": "P",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-16",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "OA60349888",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA1269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2010279",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samer Nassar
• Udi Nassar, PHARMD
• Navjot S Khurana DMD, PS (Radiant Smiles)
• Anne Marguerite Nealen, M.D.
• Richard Loren Nelson, R PH
• Jakdej Nikomborirak, M.D.
• Gregory John Norell, DDS
• Rebecca Norem
• Penelope O'Brien, LMP
• Paul O'Neal

• Physician Assistant in Sunnyside, WA
• Providers in Sunnyside, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; 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.