NPIMap

Individual provider Active NPI

Trent Lyman, PAC

  • Physician Assistant
  • E Wenatchee, WA
National Provider Identifier
1821458969
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60634542 Issued in WA
Practice address
100 Highline Dr
E Wenatchee, WA 98802-5341
Phone
(509) 662-1511
NPI assigned
Mar 2, 2016
Sex
Male
Sole proprietor
No

Organizations & group practices 28

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.

View all 28

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Washington Health Services Association 708 clinicians
Chelan County Public Hospital District No 2 18 clinicians

Practice addresses (Care Compare)

100 Highline Dr
E Wenatchee, WA 98802-5341
Phone (509) 663-8711

110 S Apple Blossom Dr
Chelan, WA 98816-8810
Phone (509) 682-3300

933 Red Apple Rd
Wenatchee, WA 98801-3370
Phone (509) 663-8711

Hospital & facility affiliations

  • Lake Chelan Community Hospital Hospital, Chelan, WA, CCN 501334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161130000855 WA Practitioner - Physician Assistant 6507145224 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA60634542WAMDPhysician Assistant

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X WA
Physician Assistant 363A00000X PA60634542 WA Primary

Addresses

NPPES NPI Registry

Primary practice location

100 Highline Dr
E Wenatchee, WA 98802-5341

Mailing address

820 N Chelan Ave
Wenatchee, WA 98801-2028
Phone (509) 663-8711

Electronic endpoints 1

NPPES NPI Registry
TypeEndpointUseAffiliation
FHIR URL https://epicoxy.et0764.epichosted.com/FHIRProxy/api/FHIR/Rpr4/

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 13, 2024.

{
    "created_epoch": "1456876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1821458969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 N CHELAN AVE",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012028",
            "telephone_number": "509-663-8711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HIGHLINE DR",
            "city": "E WENATCHEE",
            "state": "WA",
            "postal_code": "988025341",
            "telephone_number": "509-662-1511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYMAN",
        "first_name": "TRENT",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-02",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60634542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicoxy.et0764.epichosted.com/FHIRProxy/api/FHIR/Rpr4/",
            "affiliation": "N",
            "address_1": "100 Highline Dr",
            "city": "E Wenatchee",
            "state": "WA",
            "country_code": "US",
            "postal_code": "988025341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in E Wenatchee, WA

Sources for this page

Verify at the official NPI Registry.