Tracey L Bryant, PA C
Individual provider Active NPI Physician Assistant · Kennewick, WA
NPI 1962473256 · NPPES record last updated May 13, 2015
Key facts
- NPI
- 1962473256
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA10003465 (WA)
- Practice address
- 216 W 10TH Ave
Suite 300
Kennewick, WA 99336-6300 - Phone
- (509) 586-5644
- Fax
- (509) 586-5645
- NPI assigned
- Jan 27, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Yale University School of Medicine, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- RCCH Trios Health LLC
Practice addresses (Care Compare)
216 W 10TH Ave
Kennewick, WA 99336-6304
7211 W Deschutes Ave
Suite B
Kennewick, WA 99336-7715
Phone (509) 221-6930
Hospital & facility affiliations
- Trios Health
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080108000078 | WA | Practitioner - Physician Assistant | 3173603842 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| RCCH Trios Health LLC | Current |
Accepting new patients | |
| Kennewick Public Hospital District | Past | Accepting new patients | |
| Tri Cities Community Health | Past | Accepting new patients | |
| Kendal Rae Piatt, OD, PC | Past |
Accepting new patients | |
| Lourdes Hospital LLC | Past | Accepting new patients | |
| Tri Cities OB and GYN PC | Past | Accepting new patients |
Locations
900 S Auburn St
Kennewick, WA 99336
Phone (509) 586-5111
216 W 10th Ave
Ste 204
Kennewick, WA 99336
Phone (509) 221-5520
3730 Plaza Way
Kennewick, WA 99338
Phone (509) 221-6350
520 N 4th Ave
Pasco, WA 99301
Phone (509) 544-6140
Interoperability endpoints
- tracey.bryant.1@18485.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA10003465 | WA | Yes |
Addresses
Primary practice location
216 W 10TH Ave
Suite 300
Kennewick, WA 99336-6300
Mailing address
216 W 10TH Ave
Suite 300
Kennewick, WA 99336-6300
Phone (509) 586-5644
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8349060 | Medicaid | WA |
Other providers in Kennewick, WA
- Taylor Brummett
- Tamara Brun
- Patrick (Rick) C. R. Brunk
- Kendall Augusta Brusseau
- Alexys Anne Bryant
- Bryce Holmes PLLC
- BS Chiropractic Inc
- BTR LLC
- Judy Bucio-Salas
- Elvia Bucio
All providers in Kennewick, WA · Physician Assistant in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 13, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.