Individual provider Active NPI

Mary Coleman, M.D.

  • Developmental - Behavioral Pediatrics Physician
  • Tacoma, WA
National Provider Identifier
1093743619
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X
License
G072907 Issued in CA
Practice address
5005 Main St
Tacoma
Tacoma, WA 98407-3168
Phone
(925) 360-3102
NPI assigned
Jun 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD60459088 WA
Pediatrics Physician 208000000X G72907 CA
Developmental - Behavioral Pediatrics Physician 2080P0006X MD60459088 WA
Pediatric Neurodevelopmental Disabilities Physician 2080P0008X MD60459088 WA
Developmental - Behavioral Pediatrics Physician 2080P0006X G072907 CA Primary

Addresses

Primary practice location

5005 Main St
Tacoma
Tacoma, WA 98407-3168

Mailing address

1900 Garden Rd Ste 200
Monterey, CA 93940-5334
Phone (833) 328-4523

Other identifiers 1

IdentifierTypeStateIssuer
00G729070MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150702001257 CA Practitioner - Pediatric Medicine 5890763395 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
72907CAMDClinical Social Worker
G72907CAMDPediatrics Physician
MD60459088WAMDPediatrics Physician
G072907CAMDDevelopmental - Behavioral Pediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Monterey County Memorial Hospital CurrentSince Jun 22, 2019 Accepting new patients
Pacific Coast Developmental and Behavioral Pediatrics Developmental - Behavioral Pediatrics CurrentSince Jul 9, 2025 Accepting new patients
Southern Monterey County Memorial Hospital CurrentSince Jun 22, 2019 Accepting new patients
County of Monterey Behavioral Health CurrentSince May 10, 2015 Accepting new patients
County of Monterey CurrentSince May 10, 2015 Accepting new patients
University of California San Francisco Past Accepting new patients

Locations

300 Canal St
King City, CA 93930
Phone (831) 385-6000

210 Canal St
King City, CA 93930
Phone (931) 385-7100

1900 Garden Rd
Ste 200
Monterey, CA 93940
Phone (831) 250-6770

1441 Constitution Blvd
Salinas, CA 93906
Phone (831) 261-8090

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JDEGCD

Organizations & group practices 6

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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1093743619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 GARDEN RD STE 200",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939405334",
            "telephone_number": "833-328-4523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5005 MAIN ST",
            "address_2": "TACOMA",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984073168",
            "telephone_number": "925-360-3102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "MARY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD60459088",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G72907",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "WA",
            "license": "MD60459088",
            "primary": false
        },
        {
            "code": "2080P0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neurodevelopmental Disabilities",
            "state": "WA",
            "license": "MD60459088",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "CA",
            "license": "G072907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G729070",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.