Tiffany Ickiewicz

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA054038 Issued in PA

Practice address

765 Liberty St Ste 310
Meadville, PA 16335-2569

Phone

(814) 333-7030

Fax

(814) 373-3428

NPI assigned

Jan 19, 2011

Last updated

Jul 6, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

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, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Novacare Outpatient Rehabilitation East, Inc.Group PAC ID 3678480290, shared by 15 NPIs, 493 clinicians

Primary Care ServicesGroup PAC ID 0244452258, 32 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vna Alliance Home health agency, Meadville, PA, CCN 397655
• Meadville Medical Center Hospital, Meadville, PA, CCN 390113

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: tiffany.ickiewicz@upmcdirect.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Primary Care Services

  • Internal Medicine Physician
  • Meadville, PA
  • NPI 1962804955
  Medicare reassignment Care Compare group
• Epn Hamot Urgent Care LLC

  • Family Medicine Physician
  • Erie, PA
  • NPI 1518283753
  Medicare reassignment
• Regional Health Services Inc

  • Family Medicine Physician
  • Erie, PA
  • NPI 1174520654
  Medicare reassignment
• Dedham Dialysis LLC

  dba French Creek Dialysis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Meadville, PA
  • NPI 1235693458
  NPD (past)

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

• Alliance Visiting Nurses

  dba VNA Alliance

  • Home Health Agency
  • Meadville, PA
  • NPI 1932167921
  Care Compare affiliation
• Meadville Medical Center

  • General Acute Care Hospital
  • Meadville, PA
  • NPI 1942276423
  Care Compare affiliation

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

{
    "created_epoch": "1295395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1902101140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 GROVE ST",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163352945",
            "telephone_number": "814-333-7030",
            "fax_number": "814-373-3428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 LIBERTY ST STE 310",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163352569",
            "telephone_number": "814-333-7030",
            "fax_number": "814-373-3428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICKIEWICZ",
        "first_name": "TIFFANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-19",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA054038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tiffany.ickiewicz@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dale Humes
• James D. Huselton II, MS, LPC
• Zulfiqar Hussain, M.D.
• Billie-Jo Hyde, PHARMD, RPH, BCPS
• Iadeluca Chiropractic Center Meadville PC
• Id Care and Travel Health of Northwest PA, P.C.
• Independence Care of Erie
• Stephanie Infantino
• Integrative Therapies Meadville
• Interim Healthcare of Pittsburgh, Inc. (Interim Healthcare of Meadville)

• Physician Assistant in Meadville, PA
• Providers in Meadville, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2021; 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.