Individual provider Active NPI

Tiffany Nicole Queeney, PA-C

  • Physician Assistant
  • Webster, TX
National Provider Identifier
1457658866
Registry record updated Apr 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA07557 Issued in TX
Practice address
333 N Texas Ave
Suite 4100
Webster, TX 77598-4966
Phone
(281) 317-1261
NPI assigned
Feb 21, 2011
Last updated
Apr 13, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2012

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 PA07557 TX Primary

Addresses

Primary practice location

333 N Texas Ave
Suite 4100
Webster, TX 77598-4966

Mailing address

333 N Texas Ave
Suite 4100
Webster, TX 77598-4966
Phone (281) 317-1261

Other identifiers 1

IdentifierTypeStateIssuer
000000708365OtherKYANTHEM

Other names 1

  • Tiffany Nicole Webber Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20131207000012 TX Practitioner - Physician Assistant 6608058383 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michael J Rosenblatt MD and Kathryn a Zidek MD PAGroup PAC ID 3971559410, 4 clinicians

Practice addresses (Care Compare)

110 E Medical Ctr Blvd
Webster, TX 77598-4301
Phone (832) 224-9500

18333 Egret Bay Blvd
Suite 140
Houston, TX 77058-3239
Phone (281) 218-8797

500 W Medical Ctr Blvd
Webster, TX 77598-4220
Phone (281) 332-2511

655 E Medical Ctr Blvd
Webster, TX 77598-4328
Phone (281) 286-1500

709 W Medical Ctr Blvd
Webster, TX 77598-4005
Phone (281) 332-3322

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA07557TXMDPhysician Assistant

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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": "1298246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334275200000",
    "number": "1457658866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N TEXAS AVE",
            "address_2": "SUITE 4100",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984966",
            "telephone_number": "281-317-1261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N TEXAS AVE",
            "address_2": "SUITE 4100",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775984966",
            "telephone_number": "281-317-1261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUEENEY",
        "first_name": "TIFFANY",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-21",
        "last_updated": "2012-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA07557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000708365",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "WEBBER",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Webster, TX

Sources for this page

Verify at the official NPI Registry.