Madeline Lizaida Tiffany, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

24665 Stewart St
Loma Linda, CA 92354-2744

Phone

(956) 998-2186

NPI assigned

Aug 8, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: mtiffany769603@direct.ochin.org

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.

• Newstart Medical Group Inc

  dba Blue Stone Health and Wellness

  • Rural Health Clinic/Center
  • Weimar, CA
  • NPI 1588072698
  Medicare reassignment
• Wellspace Health

  dba WellSpace Health Arden-Arcade Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Sacramento, CA
  • NPI 1548789050
  NPD (past)

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

{
    "created_epoch": "1565222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565222400000",
    "number": "1598310229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24665 STEWART ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542744",
            "telephone_number": "956-998-2186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24665 STEWART ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923542744",
            "telephone_number": "956-998-2186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIFFANY",
        "first_name": "MADELINE",
        "middle_name": "LIZAIDA",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-08",
        "last_updated": "2019-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thrifty Payless Inc (Rite Aid Pharmacy 06256)
• Irene Thung, M.D.
• Jocelyn Tiamzon, MD
• Calvin Daniel Tielman
• Linh Ai Tieu, D.O.
• Ria Tilton
• Pamela Timothy, NP
• Tristan S Tims
• Cynthia H Tinsley, M.D.
• Khin M Tint

• Physician Assistant in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.