Taj Mahalia Rock, PHYSICIAN ASSISTANT

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

MD00029104 Issued in WA

Practice address

12303 NE 130 LN
#330 Evergreen Dermatology Center
Kirkland, WA 98034

Phone

(425) 899-4300

Fax

(425) 899-4305

NPI assigned

Nov 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Taj Mahalia Cheroke Former name

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

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sound Dermatology and Skin Surgery PLLCGroup PAC ID 8123125002, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Sound Dermatology & Skin Surgery PLLC

  • Preferred Provider Organization
  • Redmond, WA
  • NPI 1538386990
  Medicare reassignment Care Compare group
• North Pacific Dermatology PS

  • Ambulatory Surgical Clinic/Center
  • Renton, WA
  • NPI 1881845907
  Medicare reassignment
• Westside Dermatology, PLLC

  • Dermatology Physician
  • Seattle, WA
  • NPI 1396862280
  Medicare reassignment
• Joanna B. Sloan MD

  • Clinic/Center
  • Bellevue, WA
  • NPI 1154400166
  NPD (past)
• Stephen William Doggett, M.D. PA

  • Radiation Oncology Physician
  • Newport Beach, CA
  • NPI 1427281666
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801973219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9710 5TH AVE NE",
            "address_2": "#201",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98115",
            "telephone_number": "206-604-0160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12303 NE 130 LN",
            "address_2": "#330 EVERGREEN DERMATOLOGY CENTER",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "98034",
            "telephone_number": "425-899-4300",
            "fax_number": "425-899-4305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROCK",
        "first_name": "TAJ",
        "middle_name": "MAHALIA",
        "name_prefix": "Mrs.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD00029104",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "AK",
            "license": "3125",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAJ",
            "last_name": "CHEROKE",
            "middle_name": "MAHALIA",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mary Robichaux, MD
• Ryan Paul Robinson
• Serena Lan Robles, LMHC, LPCC
• Isaiah Robyn
• Judy Rochlin, MSW, LICSW
• Dayna Rockett, PTA/L
• Andres Rodriguez-Sanchez Jr.
• Angelique Herminia Rodriguez
• Chrystal Juliana Rodriguez
• Fatima Michelle Rodriguez

• Dermatology Physician in Kirkland, WA
• Providers in Kirkland, WA by specialty
• Dermatology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.