Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Tiffany Ickiewicz

Individual provider Physician Assistant · NPI 1902101140

Tiffany Ickiewicz is a Physician Assistant in Meadville, Pennsylvania. Qualified in 2009, 17 years ago. Practices with Primary Care Services, a 33-clinician group and accepts Medicare assignment. Licensed in Pennsylvania.

Years since qualifying
17
Licensed in
PA
In the registry since
2011
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Practice location Address checks out

765 Liberty St Ste 310
Meadville, PA 16335-2569
Phone: (814) 333-7030
Fax: (814) 373-3428
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence MA054038 (PA)

Record details

NPI number1902101140
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJanuary 19, 2011
Last updated in NPPESJuly 6, 2021
Certification dateJuly 6, 2021
Mailing address1034 Grove St, Meadville, PA 16335-2945

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Primary Care Services — 33 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Meadville