Individual provider Active NPI

Alice Hui Fay Tin, MD, MPH

  • Family Medicine Physician
  • Seattle, WA
National Provider Identifier
1417452335
Registry record updated Mar 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD61057242 Issued in WA
Practice address
550 16TH Ave Ste 100
Seattle, WA 98122-5636
Phone
(206) 320-2484
Fax
(206) 320-4568
NPI assigned
Mar 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD61057242 WA Primary

Addresses

Primary practice location

550 16TH Ave Ste 100
Seattle, WA 98122-5636

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476

Other practice location 1

9245 Rainier Ave S
Seattle, WA 98118-5569
Phone (206) 722-8444

Other identifiers 1

IdentifierTypeStateIssuer
1417452335MedicaidWA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211028001665 WA Practitioner - Family Practice 5092061960 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD61057242WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborcare Health CurrentSince Jan 18, 2022 Accepting new patients
Neighborcare Health CurrentSince Jan 18, 2022 Accepting new patients
Swedish Health Services Family Medicine CurrentSince Oct 25, 2021 Accepting new patients
Neighborcare Health Current Accepting new patients
Neighborcare Health Current Accepting new patients
Swedish Health Services Past Accepting new patients
Swedish Health Services Past Accepting new patients

Locations

9245 Rainier Ave S
Seattle, WA 98118
Phone (206) 461-6981

1629 N 45th St
Seattle, WA 98103
Phone (206) 633-3350

4400 37th Ave S
Seattle, WA 98118
Phone (206) 296-4650

6020 35th Ave SW
Seattle, WA 98126
Phone (206) 461-6950

550 16th Ave
Ste 100
Seattle, WA 98122
Phone (206) 299-1900

550 16th Ave
Ste 400
Seattle, WA 98122
Phone (206) 320-2233

12721 30th Ave NE
Ste 101
Seattle, WA 98125
Phone (206) 417-0326

Interoperability endpoints

  • Direct secure messaging: atin1043436@wm.providencedirect.org

Organizations & group practices 7

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": "1521936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1417452335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 16TH AVE STE 100",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225636",
            "telephone_number": "206-320-2484",
            "fax_number": "206-320-4568"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9245 Rainier Ave S",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981185569",
            "country_code": "US",
            "telephone_number": "206-722-8444",
            "fax_number": "206-721-6310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIN",
        "first_name": "ALICE",
        "middle_name": "HUI FAY",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-25",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61057242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417452335",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.