Individual provider Active NPI

Tina G Branson, PA-C

  • Surgical Physician Assistant
  • Richland, WA
National Provider Identifier
1821168840
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA10004535 Issued in WA
Practice address
945 Goethals Drive
Suite 200
Richland, WA 99352
Phone
(509) 942-3627
Fax
(509) 946-2340
NPI assigned
Nov 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA10004535 WA Primary

Addresses

Primary practice location

945 Goethals Drive
Suite 200
Richland, WA 99352

Mailing address

945 Goethals Dr
Ste 200
Richland, WA 99352-3552
Phone (509) 942-3627

Other identifiers 1

IdentifierTypeStateIssuer
8436263MedicaidWA

Other names 1

  • Tina Gertrude Garand Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tbranson1106994@wm.providencedirect.org Direct

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
I20031226000352 WA Practitioner - Physician Assistant 3072411123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kadlec Regional Medical CenterGroup PAC ID 9739098617, 402 clinicians

Practice addresses (Care Compare)

1135 Jadwin Ave
Richland, WA 99352-3434
Phone (509) 942-3300

Hospital & facility affiliations

  • Kadlec Regional Medical Center Hospital, Richland, WA, CCN 500058

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kadlec Regional Medical Center CurrentSince Jan 1, 2013 Accepting new patients
Kadlec Regional Medical Center CurrentSince Jan 1, 2013 Accepting new patients
Cascade Womens Healthcare Past Accepting new patients

Locations

780 Swift Blvd
Ste 130
Richland, WA 99352
Phone (509) 942-3244

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

945 Goethals Dr
Ste 200
Richland, WA 99352
Phone (509) 942-2555

1135 Jadwin Ave
Richland, WA 99352
Phone (509) 942-3300

Organizations & group practices 3

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 1

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1821168840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 GOETHALS DR",
            "address_2": "STE 200",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993523552",
            "telephone_number": "509-942-3627",
            "fax_number": "509-942-2267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 GOETHALS DRIVE",
            "address_2": "SUITE 200",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "99352",
            "telephone_number": "509-942-3627",
            "fax_number": "509-946-2340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANSON",
        "first_name": "TINA",
        "middle_name": "G",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA10004535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8436263",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tbranson1106994@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "945 Goethals Drive",
            "address_2": "Suite 200",
            "city": "Richland",
            "state": "WA",
            "country_code": "US",
            "postal_code": "99352",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TINA",
            "last_name": "GARAND",
            "middle_name": "GERTRUDE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Richland, WA

Sources for this page

Verify at the official NPI Registry.