Organization Active NPI

Franciscan Medical Group

  • Urology Physician
  • Tacoma, WA
National Provider Identifier
1043544224
Registry record updated Sep 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
FRANCISCAN MEDICAL GROUP
Doing business as
FMG-Franciscan Urology Associates-Tacoma
Practice address
1624 S I St
#204
Tacoma, WA 98405-5016
Phone
(253) 272-8441
Fax
(253) 272-8096
NPI assigned
Sep 22, 2009
Organization subpart
Yes
Parent organization
FRANCISCAN MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 19, 2011

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

Authorized official

Name
Dean A Field, MD
Title
Chief Medical Officer
Phone
(253) 680-4009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X WA Primary

Addresses

Primary practice location

1624 S I St
#204
Tacoma, WA 98405-5016

Mailing address

1624 S I St
#204
Tacoma, WA 98405-5016
Phone (253) 272-8441

Other identifiers 1

IdentifierTypeStateIssuer
0255552OtherWASTATE L&I

Other names 1

  • FMG-Franciscan Urology Associates-Tacoma Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031111000789 WA Part B Supplier - Clinic/Group Practice 0547173866 Receives reassigned benefits from 1,720 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Part of
Enumclaw Medical Center

NPI Registry JSON

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

{
    "created_epoch": "1253577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316390400000",
    "number": "1043544224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1624 S I ST",
            "address_2": "#204",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055016",
            "telephone_number": "253-272-8441",
            "fax_number": "253-272-8096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1624 S I ST",
            "address_2": "#204",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055016",
            "telephone_number": "253-272-8441",
            "fax_number": "253-272-8096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANCISCAN MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRANCISCAN MEDICAL GROUP",
        "enumeration_date": "2009-09-22",
        "last_updated": "2011-09-19",
        "status": "A",
        "authorized_official_last_name": "FIELD",
        "authorized_official_first_name": "DEAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "253-680-4009",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "0255552",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FMG-Franciscan Urology Associates-Tacoma",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.