Active NPI
Heng Jiang
- Medical Physician Assistant
- Seattle, WA
National Provider Identifier
1720706641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA61634146
- Practice address
- 4311 11TH Ave NE Ste 200
Seattle, WA 98105-6367 - Phone
- (206) 616-4001
- NPI assigned
- Aug 16, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 63466 | CA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Medical Physician Assistant | 363AM0700X | PA61634146 | WA | Primary |
Addresses
Primary practice location
4311 11TH Ave NE Ste 200
Seattle, WA 98105-6367
Mailing address
4311 11TH Ave NE Ste 200
Seattle, WA 98105-6367
Phone (206) 616-4001
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63466 | CA | MD | Pharmacist |
| PA61634146 | WA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cep America-California | Current | Accepting new patients |
Locations
2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423
Organizations & group practices 4
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.
-
- Emergency Medicine Physician
- Renton, WA
- NPI 1861480840
-
- General Acute Care Hospital
- Seattle, WA
- NPI 1801851258
-
- Emergency Medicine Physician
- San Francisco, CA
- NPI 1023063542
-
- Emergency Medicine Physician
- Jackson, CA
- NPI 1871303974
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739923200000",
"number": "1720706641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4311 11TH AVE NE STE 200",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981056367",
"telephone_number": "206-616-4001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4311 11TH AVE NE STE 200",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981056367",
"telephone_number": "206-616-4001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JIANG",
"first_name": "HENG",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-08-16",
"last_updated": "2025-02-19",
"certification_date": "2025-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "63466",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WA",
"license": "PA61634146",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.