Individual provider Active NPI

Monica Leigh Favilla

  • Physician Assistant
  • Yakima, WA
National Provider Identifier
1407339823
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
406 S 30TH Ave Ste 206
Yakima, WA 98902-3713
Phone
(509) 574-3383
NPI assigned
Sep 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

406 S 30TH Ave Ste 206
Yakima, WA 98902-3713

Mailing address

406 S 30TH Ave Ste 206
Yakima, WA 98902-3713

Other practice location 1

406 S 30th Ave Ste 206
Yakima, WA 98902-3713
Phone (206) 574-3383

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200818002546 WA Practitioner - Physician Assistant 9234474271 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Yakima Valley Memorial PhysiciansGroup PAC ID 1557391596, 397 clinicians

Practice addresses (Care Compare)

2811 Tieton Dr
Yakima, WA 98902-3761
Phone (509) 575-8000

406 S 30TH Ave
Yakima, WA 98902-3713

Hospital & facility affiliations

  • Yakima Valley Memorial Hospital, Yakima, WA, CCN 500036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Yakima Valley Memorial Physicians CurrentSince Jul 8, 2022 Accepting new patients
Yakima Valley Memorial Physicians CurrentSince Jul 8, 2022 Accepting new patients

Locations

406 S 30th Ave
Ste 206
Yakima, WA 98902
Phone (509) 509-5743

2811 Tieton Dr
Yakima, WA 98902
Phone (509) 249-5210

Interoperability endpoints

  • Direct secure messaging: mfavilla772109@direct.multicare.org

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1536624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1407339823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 S 30TH AVE STE 206",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 S 30TH AVE STE 206",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023713",
            "telephone_number": "509-574-3383"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "406 S 30th Ave Ste 206",
            "address_purpose": "LOCATION",
            "city": "Yakima",
            "state": "WA",
            "postal_code": "989023713",
            "country_code": "US",
            "telephone_number": "206-574-3383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAVILLA",
        "first_name": "MONICA",
        "middle_name": "LEIGH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-11",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.