Tiffany Noel Carillet, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA 9102635 Issued in FL

Practice address

2107 Dairy Rd
Melbourne, FL 32904-5241

Phone

(321) 956-8224

Fax

(321) 956-8225

NPI assigned

Nov 17, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

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, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dairy Road Urgent Care LLCGroup PAC ID 9133269293, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Dairy Road Urgent Care LLC

  • Urgent Care Clinic/Center
  • Melbourne, FL
  • NPI 1265765531
  Medicare reassignment Care Compare group
• Wuesthoff Emergency Physicians PA

  • Emergency Medicine Physician
  • Rockledge, FL
  • NPI 1831192244
  NPD (past)
• Wuesthoff Emergency Physicians-Melbourne PA

  • Emergency Medicine Physician
  • Melbourne, FL
  • NPI 1508868886
  NPD (past)

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493596800000",
    "number": "1922172485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2107 DAIRY RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329045241",
            "telephone_number": "321-956-8224",
            "fax_number": "321-956-8225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2107 DAIRY RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329045241",
            "telephone_number": "321-956-8224",
            "fax_number": "321-956-8225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARILLET",
        "first_name": "TIFFANY",
        "middle_name": "NOEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2017-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA 9102635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMCA OR MCA PIN",
            "identifier": "P00450359",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "292694600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Careplans PLLC
• Alexia Carew
• Alissa Carey
• Christine Lynn Carey, MA, CCC-SLP
• Joanna Joy Knowles Carey, MA, LMFT, NCC
• Caritas Womancare Inc
• Carl Clinton Wilkinson III, D.M.D., P.a.
• Carl Jones DDS Inc
• Carl Jones DDS Inc
• Emily Reece Carleton

• Physician Assistant in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2017; 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.