NPIMap

Individual provider Active NPI

Roberto Antonio Secaira, MD

  • Specialist
  • Tacoma, WA
National Provider Identifier
1053461145
Registry record updated May 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD00039344 Issued in WA
Practice address
1802 Yakima Ave
Suite 307
Tacoma, WA 98405-4499
Phone
(253) 627-1244
Fax
(253) 627-6576
NPI assigned
Jan 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD00039344 WA Primary

Addresses

Primary practice location

1802 Yakima Ave
Suite 307
Tacoma, WA 98405-4499

Mailing address

1802 S Yakima Ave
Suite 307
Tacoma, WA 98405-5305
Phone (253) 627-1244

Other identifiers 8

IdentifierTypeStateIssuer
0162477OtherWADEPARTMENT OF L&I
1802SEOtherWAREGENCE
1800SEOtherWAREGENCE
8279440MedicaidWA
1708SEOtherWAREGENCE
4767SEOtherWAREGENCE
060068022OtherWARAILROAD MEDICARE
1300SEOtherWAREGENCE

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
I20040615001583 WA Practitioner - Other (Physician)Practitioner - Cardiovascular Disease (Cardiology) 5597749788 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Undefined Physician Type (Specify)Also: Cardiovascular Disease (Cardiology)
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

1802 Yakima Ave
Suite 307
Tacoma, WA 98405-5305
Phone (253) 627-1244

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting41
Pacemaker insertion or repair1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince Jul 1, 2011 Accepting new patients
Franciscan Medical Group Current Accepting new patients
Commonspirit Washington Past Accepting new patients
Cardiac Health Specialists PS Specialist PastSince Apr 1, 2009 Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

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

1802 Yakima Ave
Ste 307
Tacoma, WA 98405
Phone (206) 627-1244

Networks

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

Organizations & group practices 5

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 8

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": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304380800000",
    "number": "1053461145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 S YAKIMA AVE",
            "address_2": "SUITE 307",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055305",
            "telephone_number": "253-627-1244",
            "fax_number": "253-627-1244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 YAKIMA AVE",
            "address_2": "SUITE 307",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054499",
            "telephone_number": "253-627-1244",
            "fax_number": "253-627-6576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SECAIRA",
        "first_name": "ROBERTO",
        "middle_name": "ANTONIO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-11",
        "last_updated": "2011-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MD00039344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF L&I",
            "identifier": "0162477",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "1802SE",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "1800SE",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8279440",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "1708SE",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "4767SE",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060068022",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "1300SE",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.