Individual provider Active NPI

Richard Lyle Urbon Jr., M.D.

  • Internal Medicine Physician
  • Tacoma, WA
National Provider Identifier
1013905249
Registry record updated Sep 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD00046758 Issued in WA
Practice address
9040A Jackson Ave
Tacoma, WA 98431-6283
Phone
(253) 968-0166
NPI assigned
Oct 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD00046758 WA Primary

Addresses

Primary practice location

9040A Jackson Ave
Tacoma, WA 98431-6283

Mailing address

9040 Jackson Ave
Tacoma, WA 98431-0001
Phone (253) 968-0166

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
I20070511000264 WA Practitioner - Internal Medicine 8527164300 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical College of Wisconsin, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Capital Medical Center Specialty Physicians LLCGroup PAC ID 2567651771, 103 clinicians

Practice addresses (Care Compare)

3900 Capital Mall Dr SW
Olympia, WA 98502-8654
Phone (360) 704-4743

Hospital & facility affiliations

  • Capital Medical Center Hospital, Olympia, WA, CCN 500139

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Medical Center Specialty Physicians, LLC CurrentSince Mar 5, 2018 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Apr 24, 2012 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Apr 24, 2012 Accepting new patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients
Multicare Health System CurrentSince May 6, 2021 Accepting new patients
Multicare Health System CurrentSince May 6, 2021 Accepting new patients
Multicare Health System Current Accepting new patients
Grays Harbor County Public Hospital District No 1 Current Accepting new patients
Multicare Health System Past Accepting new patients

Locations

600 E Main St
Elma, WA 98541
Phone (360) 346-2222

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

3900 Capital Mall Dr SW
Olympia, WA 98502
Phone (360) 704-4743

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: rurbon002@direct.sp-mc.org

Organizations & group practices 9

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 1

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": "1128988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1013905249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-0166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040A JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984316283",
            "telephone_number": "253-968-0166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URBON",
        "first_name": "RICHARD",
        "middle_name": "LYLE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-11",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00046758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.