Individual provider Active NPI

Eunice Faith Hsu Fan, MD

  • Family Medicine Physician
  • Kent, WA
National Provider Identifier
1093342271
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
61549336 Issued in WA
Practice address
219 State Ave N Ste 220
Kent, WA 98030-4543
Phone
(253) 372-7866
NPI assigned
Mar 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 61549336 WA Primary
Family Medicine Physician 207Q00000X U0595 TX

Addresses

Primary practice location

219 State Ave N Ste 220
Kent, WA 98030-4543

Mailing address

219 State Ave N Ste 220
Kent, WA 98030-4543
Phone (253) 372-7866

Other names 1

  • Eunice Faith Hsu Fan Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230724001652 TX Practitioner - Family Practice 9133540966 Reassigns benefits to 1 organization
I20241016002188 WA Practitioner - Family Practice 9133540966 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Texas a & M University System, HSC, College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

222 State Ave N
Kent, WA 98030-4544
Phone (253) 372-7788

Hospital & facility affiliations

  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129
  • Multicare Covington Medical Center Hospital, Covington, WA, CCN 500154
  • Multicare Auburn Medical Center Hospital, Auburn, WA, CCN 500015

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as apm

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61549336WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Family Medicine CurrentSince Oct 4, 2024 Accepting new patients
Multicare Health System CurrentSince Oct 4, 2024 Accepting new patients
Multicare Health System Current Accepting new patients
Lonestar Hospital Medicine Associates, PA CurrentSince Sep 1, 2023 Accepting new patients
Multicare Health System Family Medicine Past Accepting new patients

Locations

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

2700 E Broad St
Mansfield, TX 76063
Phone (682) 242-2000

1201 E Highway 287
Midlothian, TX 76065
Phone (469) 695-2065

2400 Round Rock Ave
Round Rock, TX 78681
Phone (512) 255-6066

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

Interoperability endpoints

  • Direct secure messaging: ehsu278266@direct.sw.org
  • Direct secure messaging: ehsufan802270@direct.multicare.org

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 3

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": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1093342271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 STATE AVE N STE 220",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980304543",
            "telephone_number": "253-372-7866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 STATE AVE N STE 220",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980304543",
            "telephone_number": "253-372-7866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HSU FAN",
        "first_name": "EUNICE",
        "middle_name": "FAITH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-26",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "61549336",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "U0595",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EUNICE",
            "last_name": "HSU FAN",
            "middle_name": "FAITH",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Kent, WA

Sources for this page

Verify at the official NPI Registry.