Individual provider Active NPI

Patricia Ann Nichols, PA-C

  • Physician Assistant
  • Yakima, WA
National Provider Identifier
1689865701
Registry record updated Jan 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10004078 Issued in WA
Practice address
3810 Kern Way Ste D
Yakima, WA 98902-7805
Phone
(509) 248-4303
Fax
(509) 469-2441
NPI assigned
Aug 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 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 PA10004078 WA Primary

Addresses

Primary practice location

3810 Kern Way Ste D
Yakima, WA 98902-7805

Mailing address

3810 Kern Way Ste D
Yakima, WA 98902-7805
Phone (509) 248-4303

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
I20110216000274 WA Practitioner - Physician Assistant 5092995571 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jason Berreman, Arnp, PSGroup PAC ID 7315072303, 3 clinicians

Practice addresses (Care Compare)

3810 Kern Way
Suite D
Yakima, WA 98902-7805
Phone (509) 494-2912

Hospital & facility affiliations

  • Yakima Valley Memorial Hospital, Yakima, WA, CCN 500036
  • Kittitas Valley Community Hospital Hospital, Ellensburg, WA, CCN 501333

Merit-based Incentive Payment System (MIPS)

Final score
97.67 of 100Reported as group
Quality
100
Improvement activities
40
Cost
92.23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA10004078WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen William Doggett, M.D. PA PastSince Jan 22, 2023 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.

Hospital & facility affiliations 2

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": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673827200000",
    "number": "1689865701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 KERN WAY STE D",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989027805",
            "telephone_number": "509-248-4303",
            "fax_number": "509-469-2441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3810 KERN WAY STE D",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989027805",
            "telephone_number": "509-248-4303",
            "fax_number": "509-469-2441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-05",
        "last_updated": "2023-01-16",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10004078",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.