Individual provider Active NPI

Faith Ayumi Tierney, PA-C

  • Physician Assistant
  • New York, NY
National Provider Identifier
1679979587
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
017802 Issued in NY
Practice address
1275 York Ave
New York, NY 10065-6007
Phone
(212) 639-2000
NPI assigned
Nov 5, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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 017802 NY Primary

Addresses

Primary practice location

1275 York Ave
New York, NY 10065-6007

Mailing address

1590 Anderson Ave Apt 6D
Fort Lee, NJ 07024-2708
Phone (206) 850-0696

Other practice location 1

177 Fort Washington Ave
New York, NY 10032-3733
Phone (212) 305-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20231110000702 NY Practitioner - Physician Assistant 8325495484 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mskcc Radiology GroupGroup PAC ID 3971494683, 192 clinicians

Practice addresses (Care Compare)

1275 York Ave
New York, NY 10065-6007
Phone (212) 639-2000

Hospital & facility affiliations

  • Memorial Hospital for Cancer and Allied Diseases Hospital, New York, NY, CCN 330154

Merit-based Incentive Payment System (MIPS)

Final score
85.97 of 100Reported as group
Quality
82.74
Improvement activities
40
Cost
79.62

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
017802NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mskcc Radiology Group CurrentSince Nov 2, 2025 Accepting new patients

Locations

633 3rd Ave
Fl 4
New York, NY 10017
Phone (646) 227-3764

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: fit7001@direct.nyp.org
  • Direct secure messaging: ftierney32648@mskcc.direct-ci.com

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.

Hospital & facility affiliations 5

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": "1415145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1679979587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1590 ANDERSON AVE APT 6D",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070242708",
            "telephone_number": "206-850-0696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "212-639-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "177 Fort Washington Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100323733",
            "country_code": "US",
            "telephone_number": "212-305-2500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TIERNEY",
        "first_name": "FAITH",
        "middle_name": "AYUMI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-05",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "017802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.