NPIMap

Individual provider Active NPI

Nicholas Andrew Juan, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Kennewick, WA
National Provider Identifier
1013270875
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
MD60751696 Issued in WA
Practice address
7401 W Hood PL Ste 200
Kennewick, WA 99336-3400
Phone
(509) 591-0070
NPI assigned
Jun 18, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X Q8523 TX
Pain Medicine (Anesthesiology) Physician 207LP2900X MD60751696 WA Primary

Addresses

Primary practice location

7401 W Hood PL Ste 200
Kennewick, WA 99336-3400

Mailing address

7401 W Hood PL Ste 200
Kennewick, WA 99336-3400
Phone (509) 591-0070

Other identifiers 1

IdentifierTypeStateIssuer
2079915MedicaidWA

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
I20170615002033 WA Practitioner - Pain ManagementPractitioner - Anesthesiology 6103111349 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
University of Texas Medical Branch at Galveston, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sound Pain Alliance 43 clinicians

Practice addresses (Care Compare)

11306 Bridgeport Way SW
Lakewood, WA 98499-3037
Phone (253) 983-9390

4029 Northwest Ave
Bellingham, WA 98226-9077

5122 Olympic Dr
Suite a 204
Gig Harbor, WA 98335-1767
Phone (360) 415-9110

7200 S 180TH St
Suite 102
Tukwila, WA 98188-2988
Phone (253) 983-9390

9220 Ridgetop Blvd NW
Silverdale, WA 98383-8583
Phone (360) 415-9110

Hospital & facility affiliations

  • St Michael Medical Center Hospital, Silverdale, WA, CCN 500039
  • Olympic Medical Center Hospital, Port Angeles, WA, CCN 500072
  • St Anthony Hospital Hospital, Gig Harbor, WA, CCN 500151
  • Jefferson Healthcare Hospital, Port Townsend, WA, CCN 501323

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60751696WAMDPain Medicine (Anesthesiology) Physician

Practice roles (6 of 8)

OrganizationSpecialtyStatusNew patients
Sound Pain Alliance Pain Medicine CurrentSince Jun 1, 2019 Accepting new patients
RCCH Trios Health LLC CurrentSince Aug 1, 2018 Accepting new patients
Sound Pain Alliance Current Accepting new patients
Sound Pain Alliance CurrentSince Jun 1, 2019 Accepting new patients
Pinnicale Pain Center PastSince Jul 1, 2017 Accepting new patients
Sound Pain Alliance Past Accepting new patients

Locations

4029 Northwest Ave
Ste 301
Bellingham, WA 98226
Phone (360) 526-8685

3730 Plaza Way
Ste C6100
Kennewick, WA 99338
Phone (509) 591-0608

216 W 10th Ave
Ste 204
Kennewick, WA 99336
Phone (509) 221-5520

3810 Plaza Way
Kennewick, WA 99338
Phone (509) 221-7000

9220 Ridgetop Blvd NW
Ste 200
Silverdale, WA 98383
Phone (360) 415-9110

9220 Ridgetop Blvd NW
Ste 100
Silverdale, WA 98383
Phone (360) 308-0930

7200 S 180th St
Ste 102
Tukwila, WA 98188

Networks

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HIEDBD/Endpoint/HIEDBD

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 6

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": "1339977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1013270875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7401 W HOOD PL STE 200",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993363400",
            "telephone_number": "509-591-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7401 W HOOD PL STE 200",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993363400",
            "telephone_number": "509-591-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUAN",
        "first_name": "NICHOLAS",
        "middle_name": "ANDREW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "Q8523",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "WA",
            "license": "MD60751696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2079915",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

Verify at the official NPI Registry.