Individual provider Active NPI

Jesse Lee Mierzwiak, MD

  • Urology Physician
  • Tacoma, WA
National Provider Identifier
1013117803
Registry record updated Feb 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD60271040 Issued in WA
Practice address
3124 S 19TH St
Ste 320
Tacoma, WA 98405-2433
Phone
(253) 301-5100
NPI assigned
Jul 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MD60271040 WA Primary

Addresses

Primary practice location

3124 S 19TH St
Ste 320
Tacoma, WA 98405-2433

Mailing address

3124 S 19TH St
Ste 320
Tacoma, WA 98405-2433
Phone (253) 301-5100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120824000566 WA Practitioner - Urology 8921255050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Cincinnati College of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

1901 S Union Ave
Tacoma, WA 98405-1702

311 S L St
Tacoma, WA 98405-3720

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

Hospital & facility affiliations

  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129
  • Capital Medical Center Hospital, Olympia, WA, CCN 500139
  • Multicare Good Samaritan Hospital Hospital, Puyallup, WA, CCN 500079

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60271040WAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Aug 27, 2012 Accepting new patients
Multicare Health System CurrentSince Aug 27, 2012 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

3124 S 19th St
Ste 320
Tacoma, WA 98405
Phone (253) 301-5100

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

3124 S 19th St
Ste C320
Tacoma, WA 98405
Phone (253) 301-5100

Interoperability endpoints

  • Direct secure messaging: jmierzwiak108809@direct.multicare.org

Organizations & group practices 4

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 3

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": "1184889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361836800000",
    "number": "1013117803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3124 S 19TH ST",
            "address_2": "STE 320",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984052433",
            "telephone_number": "253-301-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3124 S 19TH ST",
            "address_2": "STE 320",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984052433",
            "telephone_number": "253-301-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIERZWIAK",
        "first_name": "JESSE",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-20",
        "last_updated": "2013-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WA",
            "license": "MD60271040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.