Individual provider Active NPI

Tiffany Michelle Tapia, PA-C

  • Physician Assistant
  • Phoenix, AZ
National Provider Identifier
1629065206
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3045 Issued in AZ
Practice address
9801 N Metro Pkwy E
Phoenix, AZ 85051-1513
Phone
(602) 249-0115
Fax
(602) 246-0837
NPI assigned
Sep 29, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 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 3045 AZ Primary

Addresses

Primary practice location

9801 N Metro Pkwy E
Phoenix, AZ 85051-1513

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380
Phone (702) 579-3203

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20041027001209 AZ Practitioner - Physician Assistant 4385606813 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Greater Phoenix Collaborative Care PCGroup PAC ID 0941503304, 111 clinicians

Practice addresses (Care Compare)

10249 W Thunderbird Blvd
Suite 100
Sun City, AZ 85351-3113
Phone (702) 480-2550

5830 N 19TH Ave
Phoenix, AZ 85015-2494
Phone (602) 336-1966

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3045AZMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Greater Phoenix Collaborative Care PC CurrentSince Sep 14, 2018 Accepting new patients

Locations

16838 E Palisades Blvd
Ste C153
Fountain Hls, AZ 85268
Phone (480) 445-9199

9801 N Metro Pkwy E
Phoenix, AZ 85051
Phone (602) 249-0115

5830 N 19th Ave
Phoenix, AZ 85015
Phone (602) 249-0115

8041 N Black Canyon Hwy
Phoenix, AZ 85021
Phone (602) 249-0115

Interoperability endpoints

  • Direct secure messaging: ttapia114553@westdirect.optum.com

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": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1629065206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 35380",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891335380",
            "telephone_number": "702-579-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9801 N METRO PKWY E",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850511513",
            "telephone_number": "602-249-0115",
            "fax_number": "602-246-0837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAPIA",
        "first_name": "TIFFANY",
        "middle_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-29",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "3045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.