Individual provider Active NPI

Mailyn Faye Williams, PA-C, RDMS, RVT

  • Physician Assistant
  • Seattle, WA
National Provider Identifier
1457925042
Registry record updated Sep 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4311 11TH Ave NE Ste 200
Seattle, WA 98105-6367
Phone
(206) 616-4001
NPI assigned
May 18, 2021
Last updated
Sep 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2021

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 NU Primary

Addresses

Primary practice location

4311 11TH Ave NE Ste 200
Seattle, WA 98105-6367

Mailing address

17425 Bettijean St
Anchorage, AK 99516-5612
Phone (612) 250-9741

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, TX2 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

Enrollment IDStateProvider typePAC IDDetails
I20211119001186 AK Practitioner - Physician Assistant 6204225840 Reassigns benefits to 3 organizations
I20220712003912 TX Practitioner - Physician Assistant 6204225840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alaska Radiology Associates IncGroup PAC ID 0648182725, 37 clinicians
Imaging Associates LLCGroup PAC ID 4284641986, 23 clinicians

Practice addresses (Care Compare)

11201 Mountain Lake Dr
Anchorage, AK 99516-1875
Phone (907) 222-4624

2280 S Woodworth Loop
Palmer, AK 99645-7412
Phone (907) 746-4646

2280 Woodworth Loop
Palmer, AK 99645
Phone (907) 565-8010

3200 Providence Dr
Anchorage, AK 99508-4615
Phone (907) 562-2211

3650 Piper St
Suite a
Anchorage, AK 99508-4692
Phone (901) 222-4624

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alaska Native Tribal Health Consortium CurrentSince Jun 30, 2022 Accepting new patients

Locations

4000 Ambassador Dr
Anchorage, AK 99508
Phone (907) 729-1900

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1621296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1457925042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17425 BETTIJEAN ST",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995165612",
            "telephone_number": "612-250-9741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4311 11TH AVE NE STE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981056367",
            "telephone_number": "206-616-4001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MAILYN",
        "middle_name": "FAYE",
        "credential": "PA-C, RDMS, RVT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-18",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.