Individual provider Active NPI

Tiffany M Waites, FNP

  • Family Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1972891364
Registry record updated May 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
808586 Issued in TX
Practice address
3600 Gaston Ave
Barnett Tower, Ste 605
Dallas, TX 75246-1800
Phone
(214) 820-7227
Fax
(214) 820-7227
NPI assigned
Jul 19, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 808586 TX Primary

Addresses

Primary practice location

3600 Gaston Ave
Barnett Tower, Ste 605
Dallas, TX 75246-1800

Mailing address

3600 Gaston Ave
Barnett Tower, Ste 605
Dallas, TX 75246-1800
Phone (214) 820-7227

Other identifiers 1

IdentifierTypeStateIssuer
285924101MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tfoster228977@direct.sw.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20111108000332 TX Practitioner - Nurse Practitioner 4385817352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

3500 Gaston Ave
FL 1
Dallas, TX 75246-2017
Phone (972) 817-6100

4001 Worth St
Dallas, TX 75246-1608

611 N Hall St
400 Baylor Scott and White Cardiology Consult
Dallas, TX 75226-1337
Phone (469) 800-7400

Hospital & facility affiliations

  • Baylor University Medical Center Hospital, Dallas, TX, CCN 450021

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
808586TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Jul 31, 2012 Accepting new patients
Healthtexas Provider Network CurrentSince Jul 31, 2012 Accepting new patients
Healthtexas Provider Network Past Accepting new patients

Locations

3600 Gaston Ave
Ste 605
Dallas, TX 75246
Phone (214) 820-8690

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

3410 Worth St
Ste 820
Dallas, TX 75246
Phone (214) 820-7400

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

Interoperability endpoints

  • Direct secure messaging: tfoster228977@direct.sw.org

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1311033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1972891364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 GASTON AVE",
            "address_2": "BARNETT TOWER, STE 605",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461800",
            "telephone_number": "214-820-7227",
            "fax_number": "214-820-7227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 GASTON AVE",
            "address_2": "BARNETT TOWER, STE 605",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461800",
            "telephone_number": "214-820-7227",
            "fax_number": "214-820-7227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAITES",
        "first_name": "TIFFANY",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-19",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "808586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "285924101",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tfoster228977@direct.sw.org",
            "affiliation": "N",
            "address_1": "3410 Worth St Ste 820",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752462003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.