Individual provider Active NPI

Janitzia Schurch Diaz, MD

  • Internal Medicine Physician
  • Tacoma, WA
National Provider Identifier
1063410926
Registry record updated Jun 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
12573 Issued in PR
Practice address
1112 S Cushman Ave
Tacoma, WA 98405-3631
Phone
(253) 593-2144
Fax
(253) 272-4125
NPI assigned
Jul 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2008

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 12573 PR Primary

Addresses

Primary practice location

1112 S Cushman Ave
Tacoma, WA 98405-3631

Mailing address

PO Box 34703
Seattle, WA 98124-1703

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
I20051228000213 WA Practitioner - Family PracticePractitioner - Internal Medicine 3274555792 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12573PRMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vpa PC Internal Medicine CurrentSince May 11, 2015 Accepting new patients
Vpa PC Internal Medicine CurrentSince May 11, 2015 Accepting new patients
Public Hospital District No 4, King County Wa Internal Medicine Past Accepting new patients
Public Hospital District No 4 King County Washington Past Accepting new patients

Locations

606 Oakesdale Ave SW
Ste C200
Renton, WA 98057
Phone (866) 259-1629

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212624000000",
    "number": "1063410926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34703",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 S CUSHMAN AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984053631",
            "telephone_number": "253-593-2144",
            "fax_number": "253-272-4125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHURCH DIAZ",
        "first_name": "JANITZIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-13",
        "last_updated": "2008-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PR",
            "license": "12573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.