Tiffany L Cooke, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3105 Issued in AZ

Practice address

13128 N 94TH Dr
Suite 100
Peoria, AZ 85381-4252

Phone

(623) 876-8816

Fax

(623) 298-0168

NPI assigned

May 16, 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. Tiffany L Wolf Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

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.

• Arizona Physician Specialists PC

  • Specialist
  • Glendale, AZ
  • NPI 1063850725
  NPD (past)
• Heartcare PC

  • Clinical Cardiac Electrophysiology Physician
  • Scottsdale, AZ
  • NPI 1003994351
  NPD (past)
• Sen T Jou MD PC

  • Infectious Disease Physician
  • Glendale, AZ
  • NPI 1801903778
  NPD (past)

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473638400000",
    "number": "1841242278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13128 N 94TH DR",
            "address_2": "SUITE 100",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814252",
            "telephone_number": "623-876-8816",
            "fax_number": "623-298-0168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13128 N 94TH DR",
            "address_2": "SUITE 100",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814252",
            "telephone_number": "623-876-8816",
            "fax_number": "623-298-0168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOKE",
        "first_name": "TIFFANY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2016-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110002318",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "3105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "WOLF",
            "middle_name": "L",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kyrie Ann Conseen, LCSW
• Arlene D Conte, M.D.
• Danielle Renee Contreras, LPC
• Mark Charles Conway, LAC
• Heather Cook
• Kristin Lee Coolidge, FNP-C
• Nathan David Coons, PHARM D.
• Joel Robin Cooper, D.O.
• Kristin Cooper, RPH
• Randy I Cooper, M.D.

• Physician Assistant in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.