Individual provider Active NPI

Brina Mackenzie Turnbull, P.A.

  • Medical Physician Assistant
  • Tacoma, WA
National Provider Identifier
1679028039
Registry record updated Oct 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA60694991 Issued in WA
Practice address
1500 N Warner St
#1035
Tacoma, WA 98416
Phone
(253) 879-1555
Fax
(253) 879-3766
NPI assigned
Aug 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1134215 WA
Medical Physician Assistant 363AM0700X PA60694991 WA Primary

Addresses

Primary practice location

1500 N Warner St
#1035
Tacoma, WA 98416

Mailing address

5901 Steilacoom Blvd SW
Lakewood, WA 98499-3120
Phone (253) 572-2842

Other names 1

  • Brina Mackenzie Lewis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20191031002542 WA Practitioner - Physician Assistant 7911239520 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pace Dermatology Associates, PLLCGroup PAC ID 5193995777, 14 clinicians

Practice addresses (Care Compare)

1901 S Union Ave
Suite B3003
Tacoma, WA 98405-1803

1910 S Meridian
Puyallup, WA 98371-7531
Phone (253) 572-2842

7502 Lakewood Dr W
Suite a
Lakewood, WA 98499-8410
Phone (253) 572-2842

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1134215WAMDPhysician Assistant
PA60694991WAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Puget Sound Past Accepting new patients

Organizations & group practices 2

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": "1471219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569888000000",
    "number": "1679028039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 STEILACOOM BLVD SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993120",
            "telephone_number": "253-572-2842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N WARNER ST",
            "address_2": "#1035",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98416",
            "telephone_number": "253-879-1555",
            "fax_number": "253-879-3766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TURNBULL",
        "first_name": "BRINA",
        "middle_name": "MACKENZIE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-15",
        "last_updated": "2019-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "1134215",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA60694991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRINA",
            "last_name": "LEWIS",
            "middle_name": "MACKENZIE",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.