Individual provider Active NPI

Tiffany A Darling, MD

  • Pediatrics Physician
  • Glendale, WI
National Provider Identifier
1871671735
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
47132-20 Issued in WI
Practice address
6791 N Green Bay Ave
Glendale, WI 53209-3422
Phone
(414) 228-4800
Fax
(414) 247-0894
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 47132-20 WI Primary

Addresses

Primary practice location

6791 N Green Bay Ave
Glendale, WI 53209-3422

Mailing address

36745 Aiken Rd
Bayfield, WI 54814-4579
Phone (715) 779-3707

Other identifiers 1

IdentifierTypeStateIssuer
34501100MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161012000040 WI Practitioner - General Practice 0042508889 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
47132-20WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Red Cliff Band of Lake Superior Chippewa Indians CurrentSince Sep 6, 2016 Accepting new patients
Red Cliff Band of Lake Superior Chippewa Indians CurrentSince Sep 6, 2016 Accepting new patients

Locations

36745 Aiken Rd
Bayfield, WI 54814
Phone (715) 779-3707

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1871671735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36745 AIKEN RD",
            "city": "BAYFIELD",
            "state": "WI",
            "postal_code": "548144579",
            "telephone_number": "715-779-3707",
            "fax_number": "715-779-3362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6791 N GREEN BAY AVE",
            "city": "GLENDALE",
            "state": "WI",
            "postal_code": "532093422",
            "telephone_number": "414-228-4800",
            "fax_number": "414-247-0894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARLING",
        "first_name": "TIFFANY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "47132-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34501100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, WI

Sources for this page

Verify at the official NPI Registry.