Matthew Julian Duenas, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD61181715 Issued in WA

Practice address

24920 104TH Ave SE
Kent, WA 98030-6443

Phone

(425) 690-3420

Fax

(425) 690-9420

NPI assigned

May 30, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Valley Medical Group-Renton

  • General Acute Care Hospital
  • Renton, WA
  • NPI 1619209574

  Family Medicine

  Medicare reassignment NPD

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

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1063070530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24920 104TH AVE SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980306443",
            "telephone_number": "425-690-3420",
            "fax_number": "425-690-3420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24920 104TH AVE SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980306443",
            "telephone_number": "425-690-3420",
            "fax_number": "425-690-9420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUENAS",
        "first_name": "MATTHEW",
        "middle_name": "JULIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-30",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61181715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2136098",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dr. Vyacheslav a. Borisenko, D.C., P.S. (NW Spinal Rehabilitation Clinic)
• Philip Drasny, BCBA
• Kaitlin Dresdner, BCBA
• Fartun A Duale
• James Bayard Dubois, D.D.S., P.S.
• Deanne Lorraine Duff, LMP, RC
• Diane Dufner Sanders, ARNP
• Affing Dukuly
• Angela Duncan
• Dawn M. Dunn, P.T.

• Family Medicine Physician in Kent, WA
• Providers in Kent, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.