Individual provider Active NPI

Tiffany Fasano, PA-C

  • Physician Assistant
  • Silverdale, WA
National Provider Identifier
1760852545
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61263669 Issued in WA
Practice address
1950 NW Myhre Rd FL 3
Silverdale, WA 98383-7662
Phone
(564) 240-4200
Fax
(564) 240-4299
NPI assigned
Oct 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

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 PA61263669 WA Primary
Medical Physician Assistant 363AM0700X 9541054-1206 UT

Addresses

Primary practice location

1950 NW Myhre Rd FL 3
Silverdale, WA 98383-7662

Mailing address

1950 NW Myhre Rd FL 3
Silverdale, WA 98383-7662
Phone (564) 240-4200

Other identifiers 1

IdentifierTypeStateIssuer
2211780MedicaidWA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address tfasano119563@direct.med.utah.edu Direct UNIVERSITY OF UTAH
Direct Messaging Address tfasano753518@fhsce.catholichealth.net Direct Franciscan Medical Group

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
I20220825003348 WA Practitioner - Physician Assistant 5890005078 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

1800 NW Myhre Rd
Silverdale, WA 98383-7663
Phone (564) 240-1000

1812 S J St
Suite 120
Tacoma, WA 98405-4965
Phone (253) 428-2200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince Aug 1, 2022 Accepting new patients
Franciscan Medical Group CurrentSince Aug 1, 2022 Accepting new patients
Franciscan Medical Group Physician Assistant PastSince Sep 25, 2022 Accepting new patients

Locations

1950 NW Myhre Rd
Fl 3
Silverdale, WA 98383
Phone (564) 240-4200

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Interoperability endpoints

  • Direct secure messaging: tfasano119563@direct.med.utah.edu

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.

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": "1444089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1760852545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 NW MYHRE RD FL 3",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983837662",
            "telephone_number": "564-240-4200",
            "fax_number": "564-240-4299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 NW MYHRE RD FL 3",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983837662",
            "telephone_number": "564-240-4200",
            "fax_number": "564-240-4299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASANO",
        "first_name": "TIFFANY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-06",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61263669",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": "9541054-1206",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2211780",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tfasano119563@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "UNIVERSITY OF UTAH",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tfasano753518@fhsce.catholichealth.net",
            "affiliation": "Y",
            "affiliationName": "Franciscan Medical Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1950 NW Myhre Rd Fl 3",
            "city": "Silverdale",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983837662",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Silverdale, WA

Sources for this page

Verify at the official NPI Registry.