Individual provider Active NPI

Salvador Luna, PA-C

  • Medical Physician Assistant
  • Puyallup, WA
National Provider Identifier
1093406985
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA61459657 Issued in WA
Practice address
413 29TH St NE Ste I
Puyallup, WA 98372-7154
Phone
(855) 255-1750
Fax
(855) 255-0905
NPI assigned
May 19, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA61459657 WA
Medical Physician Assistant 363AM0700X PA61459657 WA Primary

Addresses

Primary practice location

413 29TH St NE Ste I
Puyallup, WA 98372-7154

Mailing address

1832 S 324TH PL
Federal Way, WA 98003-8505
Phone (253) 835-8979

Other practice location 1

1832 S 324th Pl
Federal Way, WA 98003-8505
Phone (253) 835-8979

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240315003036 WA Practitioner - Physician Assistant 5496191157 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ramon C Sanchez, M.D, LLC CurrentSince Jan 1, 2024 Accepting new patients
Mario E. Luna, M.D. Inc. Current Accepting new patients
United Wound Healing Accountable Care Consultants PLLC Physician Assistant CurrentSince Mar 1, 2024 Accepting new patients

Locations

1832 S 324th Pl
Federal Way, WA 98003
Phone (253) 835-8479

413 29th St NE
Ste I
Puyallup, WA 98372

2913 5th Ave NE
Ste 101
Puyallup, WA 98372
Phone (253) 905-0646

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": "1684454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1093406985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1832 S 324TH PL",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980038505",
            "telephone_number": "253-835-8979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 29TH ST NE STE I",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983727154",
            "telephone_number": "855-255-1750",
            "fax_number": "855-255-0905"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1832 S 324th Pl",
            "address_purpose": "LOCATION",
            "city": "Federal Way",
            "state": "WA",
            "postal_code": "980038505",
            "country_code": "US",
            "telephone_number": "253-835-8979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUNA",
        "first_name": "SALVADOR",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-19",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61459657",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA61459657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.