Individual provider Active NPI

Millie Y Tung, MD FACP

  • Nephrology Physician
  • Bellevue, WA
National Provider Identifier
1558354191
Registry record updated Dec 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD00014377 Issued in WA
Practice address
2015 116TH Ave NE
Suite B
Bellevue, WA 98004-3031
Phone
(425) 453-8406
Fax
(425) 453-4173
NPI assigned
Aug 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD00014377 WA
Nephrology Physician 207RN0300X MD00014377 WA Primary

Addresses

Primary practice location

2015 116TH Ave NE
Suite B
Bellevue, WA 98004-3031

Mailing address

PO Box 13684
Seattle, WA 98198-1010
Phone (425) 453-8406

Other identifiers 1

IdentifierTypeStateIssuer
1520501MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00014377WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Millie Y. Tung, M.D. Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197590400000",
    "number": "1558354191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13684",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981981010",
            "telephone_number": "425-453-8406",
            "fax_number": "425-453-4173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 116TH AVE NE",
            "address_2": "SUITE B",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043031",
            "telephone_number": "425-453-8406",
            "fax_number": "425-453-4173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUNG",
        "first_name": "MILLIE",
        "middle_name": "Y",
        "credential": "MD FACP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-30",
        "last_updated": "2007-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00014377",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WA",
            "license": "MD00014377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1520501",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.