Individual provider Active NPI

Tiffany Wong

  • Physician Assistant
  • Mesa, AZ
National Provider Identifier
1659065092
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
5850 E Still Cir
Mesa, AZ 85206-3618
Phone
(480) 219-6000
NPI assigned
Jun 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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 CA Primary

Addresses

Primary practice location

5850 E Still Cir
Mesa, AZ 85206-3618

Mailing address

5850 E Still Cir
Mesa, AZ 85206-3618

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20251222000877 CA Practitioner - Physician Assistant 5496240020 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the University of CaliforniaGroup PAC ID 8022922475, 562 clinicians
Regents of the Univ of CaGroup PAC ID 3375456619, 1,571 clinicians

Practice addresses (Care Compare)

2400 Del Paso Rd
Suite 145
Sacramento, CA 95834-9629
Phone (916) 928-3940

271 Turnpike Dr
Folsom, CA 95630-8098
Phone (916) 985-9200

3301 C St
Sacramento, CA 95816-3300
Phone (916) 734-6805

Hospital & facility affiliations

  • University of California Davis Medical Center Hospital, Sacramento, CA, CCN 050599

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
65788CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca CurrentSince Dec 17, 2025 Accepting new patients
Regents of the University of California CurrentSince Dec 17, 2025 Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the Univ of Ca CurrentSince Dec 17, 2025 Accepting new patients
Regents of the University of California CurrentSince Dec 17, 2025 Accepting new patients

Locations

2660 W Covell Blvd
Davis, CA 95616
Phone (530) 747-3000

2440 W Covell Blvd
Ste 104
Davis, CA 95616
Phone (530) 747-3000

8110 Laguna Blvd
Elk Grove, CA 95758
Phone (916) 683-3955

271 Turn Pike Dr
Folsom, CA 95630
Phone (916) 985-9200

2261 Douglas Blvd
Roseville, CA 95661
Phone (916) 783-1044

3301 C St
Ste 1300
Sacramento, CA 95816
Phone (916) 734-6111

3301 C St
Sacramento, CA 95816
Phone (916) 734-6111

4860 Y St
Ste 200
Sacramento, CA 95817
Phone (916) 734-3761

2400 Del Paso Rd
Ste 145
Sacramento, CA 95834
Phone (916) 928-3940

Organizations & group practices 6

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.

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": "1686096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1659065092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5850 E STILL CIR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5850 E STILL CIR",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063618",
            "telephone_number": "480-219-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "TIFFANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-07",
        "last_updated": "2025-06-11",
        "certification_date": "2025-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.