Individual provider Active NPI

Cynthia Tammar Kertesz Fierstein, MD

  • Pediatrics Physician
  • Tacoma, WA
National Provider Identifier
1063508158
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD00031980 Issued in WA
Practice address
1628 South Mildred
#101
Tacoma, WA 98465
Phone
(253) 564-8005
Fax
(253) 627-0855
NPI assigned
Oct 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD00031980 WA Primary

Addresses

Primary practice location

1628 South Mildred
#101
Tacoma, WA 98465

Mailing address

316 Martin Luther King Jr Way
#212
Tacoma, WA 98405
Phone (253) 383-5777

Other identifiers 1

IdentifierTypeStateIssuer
1098417MedicaidWA

Other names 1

  • Cynthia Kertesz Professional name

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
I20070507000206 WA Practitioner - Pediatric Medicine 4385740455 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00031980WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Association of CHMC and University Physicians Pediatrics CurrentSince Oct 31, 2011 Accepting new patients
The Association of Chrmc and University Physicians Pediatrics CurrentSince Oct 31, 2011 Accepting new patients
The Association of University Physicians CurrentSince Jul 1, 2014 Accepting new patients

Locations

900 Pacific Ave
Ste 100
Everett, WA 98201
Phone (425) 304-6080

4245 Roosevelt Way NE
Seattle, WA 98105
Phone (206) 598-4055

4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

Organizations & group practices 3

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063508158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 MARTIN LUTHER KING JR WAY",
            "address_2": "#212",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98405",
            "telephone_number": "253-383-5777",
            "fax_number": "253-627-0855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1628 SOUTH MILDRED",
            "address_2": "#101",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98465",
            "telephone_number": "253-564-8005",
            "fax_number": "253-627-0855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERTESZ FIERSTEIN",
        "first_name": "CYNTHIA",
        "middle_name": "TAMMAR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00031980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1098417",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CYNTHIA",
            "last_name": "KERTESZ",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.