NPIMap

Individual provider Active NPI

Xin Jie Luo, MD

  • Family Medicine Physician
  • Seattle, WA
National Provider Identifier
1003106675
Registry record updated Aug 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD61114625 Issued in WA
Practice address
4755 Fauntleroy Way SW
Seattle, WA 98116-4647
Phone
(206) 201-0551
Fax
(206) 201-0552
NPI assigned
Apr 15, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD61114625 WA Primary

Addresses

Primary practice location

4755 Fauntleroy Way SW
Seattle, WA 98116-4647

Mailing address

4755 Fauntleroy Way SW
Seattle, WA 98116-4647
Phone (206) 201-0551

Other identifiers 1

IdentifierTypeStateIssuer
2175619MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address xluo686024@fhsce.catholichealth.net Direct Franciscan Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210610000438 WA Practitioner - Family Practice 8921226390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

4755 Fauntleroy Way SW
Suite 110
Seattle, WA 98116-4669
Phone (206) 201-0551

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD61114625WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince May 31, 2021 Accepting new patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group Family Medicine CurrentSince May 31, 2021 Accepting new patients

Locations

34503 9th Ave S
Ste 130
Federal Way, WA 98003
Phone (253) 835-5340

4755 Fauntleroy Way SW
Ste 110
Seattle, WA 98116
Phone (206) 201-0551

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Networks

  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e
  • WA PPO C-SNP

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JJGDBA/Endpoint/JJGDBA
  • Direct secure messaging: xluo686024@fhsce.catholichealth.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1302825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1003106675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4755 FAUNTLEROY WAY SW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981164647",
            "telephone_number": "206-201-0551",
            "fax_number": "206-201-0552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4755 FAUNTLEROY WAY SW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981164647",
            "telephone_number": "206-201-0551",
            "fax_number": "206-201-0552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUO",
        "first_name": "XIN",
        "middle_name": "JIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-15",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61114625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2175619",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "xluo686024@fhsce.catholichealth.net",
            "affiliation": "Y",
            "affiliationName": "Franciscan Medical Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4755 Fauntleroy Way SW",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981164647",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.