TYLER JAY PEAKE PA-C
NPI 1184067951
Physician Assistant in Vancouver, WA

Q: What is Tyler Peake's NPI number?

The NPI number for Tyler Peake is 1184067951. It was assigned to this individual provider in the NPPES registry on April 11, 2013.

Q: What is Tyler Peake's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Tyler Peake was last updated on September 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 11, 2013PECOS EnrolledAccepts Medicare Assignment

3101 SE 192ND AVE STE 106, VANCOUVER, WA 98683(360) 553-7400 Get Directions Write a Review

NPPES record last updated: September 28, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 28, 2022, Mar 17, 2018, Jan 10, 2018 (3 updates tracked since 2018).

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About Tyler Jay Peake Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TYLER JAY PEAKE PA-C (NPI 1184067951) is an individual physician assistant in Vancouver, Washington, licensed in Washington (PA60517964) and active in the NPI registry since April 2013. He is enrolled in Medicare PECOS, is affiliated with Peacehealth St John Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1184067951

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameTYLER JAY PEAKECredential: PA-C

Location Address3101 SE 192ND AVE STE 106Vancouver, WA 98683-1443

Mailing AddressPo Box 3158Portland, OR 97208-3158 · (503) 215-6494

Phone(360) 553-7400

Sole ProprietorNo

Medical School CMSOtherGraduated 2014

Enumeration DateApril 11, 2013

Last NPPES UpdateSeptember 28, 20223 updates tracked since enumeration

NPPES CertifiedSeptember 28, 2022

✔ NPI 1184067951 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in WA · PA60517964

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

3101 SE 192ND AVE STE 106, Vancouver, WA 98683

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Secondary Practice Locations 2

Location 119005 SE 34th StVancouver, WA 98683-1450 · Phone (360) 726-6720

Location 23181 SW Sam Jackson Park Rd # Gh219Portland, OR 97239-3011 · Phone (503) 494-1484

Other Identifiers 1

Medicaid1184067951WA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., PacificSource Health Plans and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Tyler Jay Peake Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5092030650

PECOS Enrollment IDI20150203000889

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

187 services122 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

37 services29 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

21 services21 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

15 services14 patients

Routine electrocardiogram (ecg) using at least 12 leads with tracing 93005

An Electrocardiogram (ECG) is a simple, painless test that records the heart's electrical activity. Using 12 leads attached to your skin, it generates a tracing of your heart rhythm. It helps detect any heart problems by showing the timing and strength of electrical signals passing through each part of your heart.

12 services12 patients

Automated urinalysis test 81003

An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.

11 services11 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Peacehealth St John Medical Center

Acute Care Hospitals · Longview, WA

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number500041

Location1615 Delaware StreetLongview, WA 98632 · Cowlitz County

Emergency services Birthing friendly

Peacehealth Southwest Medical Center

Acute Care Hospitals · Vancouver, WA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number500050

Location400 NE Mother Joseph PlaceVancouver, WA 98668 · Clark County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98683 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$88.29 typical visit price

range $57.27 – $172.80

Typical copayment $22.07 (range $14.31 – $43.20)

Most-billed visit code 99203

Established Patient

$71.29 typical visit price

range $18.56 – $141.11

Typical copayment $17.82 (range $4.64 – $35.27)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each E0955

DME-Wheelchairs · category DD021N

1 supplier12 claims12 services$13.70 avg. paid by Medicare

Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for joystick, other control interface or positioning accessory E1028

DME-Wheelchairs · category DD021N

1 supplier12 claims12 services$13.99 avg. paid by Medicare

Manual adult size wheelchair, includes tilt in space E1161

DME-Wheelchairs · category DD000N

1 supplier12 claims12 services$185.99 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FANG-YU LEE MD

Family Medicine