MRS. MOON V TINAJERO-SIMMALY PA-C
NPI 1295330694
Physician Assistant in Vancouver, WA

Q: What is Moon Tinajero-simmaly's NPI number?

The NPI number for Moon Tinajero-simmaly is 1295330694. It was assigned to this individual provider in the NPPES registry on December 2, 2020. The provider is also known as Katherine Tinajero.

Q: What is Moon Tinajero-simmaly's specialty?

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

Active since December 02, 2020PECOS EnrolledAccepts Medicare Assignment

2101 NE 139TH ST STE 460, VANCOUVER, WA 98686(360) 487-2727 Get Directions Write a Review

NPPES record last updated: April 30, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 30, 2024, Nov 15, 2023, Oct 20, 2022 and 3 more (6 updates tracked since 2020).

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About Mrs. Moon V Tinajero-simmaly Pa-c NPPES

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

MRS. MOON V TINAJERO-SIMMALY PA-C (NPI 1295330694) is an individual physician assistant in Vancouver, Washington, licensed in Washington (PA61511235) and active in the NPI registry since December 2020. She is enrolled in Medicare PECOS, is affiliated with Legacy Salmon Creek Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1295330694

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMRS. MOON V TINAJERO-SIMMALYCredential: PA-C

Location Address2101 NE 139TH ST STE 460Vancouver, WA 98686-2325

Mailing AddressPo Box 2077Portland, OR 97208-2077 · (503) 413-3900

Phone(360) 487-2727

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateDecember 2, 2020

Last NPPES UpdateApril 30, 20246 updates tracked since enumeration

NPPES CertifiedApril 30, 2024

✔ NPI 1295330694 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Licenses✔ Licensed in WA · PA61511235✔ Licensed in NV · PA2358✔ Licensed in CA · 58655

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.

2101 NE 139TH ST STE 460, Vancouver, WA 98686

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Other Names 1

Former Name (1)Katherine Tinajero

Secondary Practice Locations 2

Location 16170 N Durango Dr Ste 130Las Vegas, NV 89149-3923 · Phone (702) 940-1550 · Fax (702) 940-1551

Location 29280 W Sunset Rd Ste 426Las Vegas, NV 89148-4862 · Phone (702) 688-8110 · Fax (702) 891-5080

Other Identifiers 2

OtherPA2358NV · State License

Medicaid1295330694NV

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., Regence BlueCross BlueShield of Oregon.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

Mrs. Moon V Tinajero-simmaly 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 ID2567878937

PECOS Enrollment IDI20240513003527

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 4

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.

66 services62 patients

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

30 services28 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.

26 services23 patients

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

13 services13 patients

Hospital Affiliations CMS Care Compare

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

Legacy Salmon Creek Medical Center

Acute Care Hospitals · Vancouver, WA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number500150

Location2211 NE 139th StreetVancouver, WA 98686 · Clark County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98686 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.

Other Providers at the Same Location NPPES 7

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

JESSICA IRENE ELLIGOTT CDCES, MS, RDN, CDN

Registered Nurse (Diabetes Educator)