Nicole Fang PO, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA61592676 Issued in WA

Practice address

1600 116TH Ave NE Ste 204
Bellevue, WA 98004-3056

Phone

(206) 395-4422

Fax

(888) 688-4167

NPI assigned

Oct 16, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Midwestern University, Chicago College of Osteopathic Med, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Dr. Attaman, PLLCGroup PAC ID 4688702103, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Dr. Attaman, PLLC

  • Interventional Pain Medicine Physician
  • Bellevue, WA
  • NPI 1346567419
  Medicare reassignment Care Compare group

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1729036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1750101358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 116TH AVE NE STE 204",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043056",
            "telephone_number": "206-395-4422",
            "fax_number": "888-688-4167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 116TH AVE NE STE 204",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043056",
            "telephone_number": "206-395-4422",
            "fax_number": "888-688-4167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PO",
        "first_name": "NICOLE",
        "middle_name": "FANG",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-16",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61592676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roger Jason Plog
• Erik Hamilton Ploof
• Pmo Care, PLLC
• Pmsi Pacific Mothers Support, Inc.
• PNW Family Medicine PLLC
• Podiatric Physicians and Surgeons P.S.
• Anne Marie Poe, L.M.P
• Delaney Poggemann
• Maynard L Pohl, OD
• Polaris Family Behavioral Health, PLLC

• Physician Assistant in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.