Individual provider Active NPI

Calvin Tian Yi, PA-C

  • Physician Assistant
  • Renton, WA
National Provider Identifier
1417676966
Registry record updated Jul 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61489752 Issued in WA
Practice address
5627 NE 1St Cir
Renton, WA 98059-2900
Phone
(425) 647-8765
NPI assigned
Aug 26, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2024

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 PA61489752 WA Primary

Addresses

Primary practice location

5627 NE 1St Cir
Renton, WA 98059-2900

Mailing address

5627 NE 1St Cir
Renton, WA 98059-2900
Phone (425) 647-8765

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
I20240112002948 WA Practitioner - Physician Assistant 0143671206 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

15870 1St Ave S
Suite 101
Burien, WA 98148-1301
Phone (206) 242-2501

222 State Ave N
Kent, WA 98030-4544
Phone (253) 372-7788

23131 Bothell Everett Hwy
Suite B
Bothell, WA 98021-9362
Phone (425) 483-3335

321 Ramsay Way
Suite 104
Kent, WA 98032-4544
Phone (253) 372-7960

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Dec 14, 2023 Accepting new patients
Multicare Health System CurrentSince Dec 14, 2023 Accepting new patients
Multicare Health System Physician Assistant Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

Interoperability endpoints

  • Direct secure messaging: cyi696518@direct.multicare.org

Organizations & group practices 4

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": "1661472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722384000000",
    "number": "1417676966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5627 NE 1ST CIR",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980592900",
            "telephone_number": "425-647-8765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5627 NE 1ST CIR",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980592900",
            "telephone_number": "425-647-8765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YI",
        "first_name": "CALVIN",
        "middle_name": "TIAN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-26",
        "last_updated": "2024-07-31",
        "certification_date": "2024-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61489752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.