TAVIS DICKERSON-YOUNG MD
NPI 1689092363
Pediatrics - Pediatric Emergency Medicine in Seattle, WA

Active since March 31, 2014PECOS EnrolledAccepts Medicare Assignment
4800 SAND POINT WAY NE # MB.7.520, SEATTLE, WA 98105(206) 987-2599 Get Directions Write a Review

NPPES record last updated: August 18, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 18, 2021, Oct 23, 2019, Mar 30, 2017 (3 updates tracked since 2017).

About Tavis Dickerson-young Md NPPES

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

TAVIS DICKERSON-YOUNG MD (NPI 1689092363) is an individual pediatric emergency medicine provider in Seattle, Washington, licensed in Washington (MD60741027) and active in the NPI registry since March 2014. He is enrolled in Medicare PECOS and is a graduate of University Of Southern California Keck School Of Medicine (2014).

NPPES Registry Identity

NPI1689092363
Entity TypeIndividualMale
Primary Taxonomy2080P0204X
Provider Legal NameTAVIS DICKERSON-YOUNGCredential: MD
Location Address4800 SAND POINT WAY NE # MB.7.520Seattle, WA 98105-3901
Mailing Address4800 Sand Point Way Ne, Mailstop Mb.7.520Seattle, WA 98105-3901
Sole ProprietorNo
Medical School CMSUniversity Of Southern California Keck School Of MedicineGraduated 2014
Enumeration DateMarch 31, 2014
Last NPPES UpdateAugust 18, 20213 updates tracked since enumeration
NPPES CertifiedAugust 18, 2021
NPI 1689092363 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPediatrics · Pediatric Emergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080P0204X
License Licensed in WA · MD60741027
Definition

A pediatrician who has special qualifications to manage emergencies in infants and children.

Also ListedPediatricsTaxonomy 208000000X · License MD60741027 (WA)
4800 SAND POINT WAY NE # MB.7.520, Seattle, WA 98105

Accepted 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

Tavis Dickerson-young Md 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 ID3577883727
PECOS Enrollment IDI20170411001561
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.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tavis Dickerson-young's NPI number?

The NPI number for Tavis Dickerson-young is 1689092363. It was assigned to this individual provider in the NPPES registry on March 31, 2014.

Where is Tavis Dickerson-young located?

Tavis Dickerson-young practices at 4800 Sand Point Way NE # Mb.7.520, Seattle, WA 98105. The listed phone number is (206) 987-2599.

What is Tavis Dickerson-young's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Emergency Medicine, with taxonomy code 2080P0204X.

Is Tavis Dickerson-young enrolled in Medicare?

Yes. Tavis Dickerson-young is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Tavis Dickerson-young accept?

Health plans from Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Tavis Dickerson-young as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Tavis Dickerson-young was last updated on August 18, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.