NPIMap

Individual provider Active NPI

Tiffin Clegg, MD

  • Family Medicine Physician
  • Silverdale, WA
National Provider Identifier
1982695219
Registry record updated Feb 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00041312 Issued in WA
Practice address
9398 Ridgetop Blvd NW
Silverdale, WA 98383-8505
Phone
(360) 782-3200
Fax
(360) 782-3240
NPI assigned
Nov 4, 2005
Last updated
Feb 11, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00041312 WA Primary

Addresses

Primary practice location

9398 Ridgetop Blvd NW
Silverdale, WA 98383-8505

Mailing address

9621 Ridgetop Blvd NW
Silverdale, WA 98383-8502
Phone (360) 782-3600

Other identifiers 1

IdentifierTypeStateIssuer
1041265MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tiffin.clegg@tdc.directbygreenway.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040506000105 WA Practitioner - Family Practice 1052309077 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

9398 Ridgetop Blvd NW
Silverdale, WA 98383-8505
Phone (360) 782-3200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group Family Medicine CurrentSince Sep 3, 2016 Accepting new patients
Franciscan Medical Group CurrentSince Sep 3, 2016 Accepting new patients
Peninsula Community Health Services Family Medicine Past Accepting new patients
Franciscan Medical Group Family Medicine Past Accepting new patients
Peninsula Community Health Services Past Accepting new patients

Locations

450 S Kitsap Blvd
Ste 250
Port Orchard, WA 98366
Phone (360) 782-3000

19245 7th Ave NE
Poulsbo, WA 98370
Phone (360) 782-3500

19245 7th Ave NE
#O
Poulsbo, WA 98370
Phone (360) 782-3500

2200 NW Myhre Rd
Silverdale, WA 98383
Phone (360) 830-1100

9398 Ridgetop Blvd NW
Silverdale, WA 98383
Phone (360) 782-3200

9398 Ridgetop Blvd NW
#O
Silverdale, WA 98383
Phone (360) 782-3200

9621 Ridgetop Blvd NW
Silverdale, WA 98383
Phone (360) 782-3300

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Interoperability endpoints

  • Direct secure messaging: tiffin.clegg@tdc.directbygreenway.com

Organizations & group practices 6

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.

Hospital & facility affiliations 6

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": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1982695219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9621 RIDGETOP BLVD NW",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838502",
            "telephone_number": "360-782-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9398 RIDGETOP BLVD NW",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983838505",
            "telephone_number": "360-782-3200",
            "fax_number": "360-782-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEGG",
        "first_name": "TIFFIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00041312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1041265",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tiffin.clegg@tdc.directbygreenway.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9398 Ridgetop Blvd NW",
            "city": "Silverdale",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983838505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Silverdale, WA

Sources for this page

Verify at the official NPI Registry.