TATYANA B PECK (PA-C) – Physician Assistant, NPI 1669611380
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,282 PHYSICIAN ASSISTANT in WA
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Provider Addresses for TATYANA B PECK (PA-C)
10634, East Riverside Drive, Bothell, King County, Washington, 98011, United States
SUITE 130
BOTHELL, WA 980113757
Phone: (425) 806-5021
Fax: (425) 486-3949
Type: Location
Bothell Post Office, 10500, Beardslee Boulevard, Wayne, Bothell, King County, Washington, 98041, United States
BOTHELL, WA 980411287
Phone: (425) 806-5021
Fax: (425) 486-3949
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 14 Open Payments records for all available years, with a total value of $315.
Total Amount is formed as General ($315) + Research ($0) + Ownership ($0) = $315.
Last reported payment date: 2023-05-23 • Largest payer in this snapshot: Alkermes, Inc. ($69).
Total Amount
$315
General + Research + Ownership
Payments
14
Total payment records
General Amount
$315
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-05-23
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-09-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20110112000984 | I | Physician Assistant | WA | TBD |
| I20250930001509 | I | Physician Assistant | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 75 | 25 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 36 | 15 | $0 |
Insurance plans in this area (ZIP 98011)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Mental Health Counselor | FL | |
| Mental Health Counselor | FL | |
| Mental Health Counselor | FL | |
| Mental Health Counselor | IL | |
| Clinical Social Worker | VA |
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