Individual provider Active NPI

Waldemar Lugo-Alvarez, M.D.

  • Internal Medicine Physician
  • Omak, WA
National Provider Identifier
1124152905
Registry record updated Oct 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD60601420 Issued in WA
Practice address
1003 Koala Ave
Omak, WA 98841-9247
Phone
(509) 422-5700
Fax
(509) 422-7680
NPI assigned
Mar 15, 2007
Last updated
Oct 26, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2016

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 MD60601420 WA Primary

Addresses

Primary practice location

1003 Koala Ave
Omak, WA 98841-9247

Mailing address

PO Box 1340
Okanogan, WA 98840-1340
Phone (509) 422-5700

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
I20160420000984 WA Practitioner - Internal Medicine 3375619810 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University Central del Caribe Escuela de Medicina, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Health CentersGroup PAC ID 9739076217, 31 clinicians

Practice addresses (Care Compare)

1003 Koala Dr
Omak, WA 98841-9247
Phone (509) 422-5700

716 1St Ave S
Okanogan, WA 98840-9679
Phone (509) 422-5700

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60601420WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Health Centers Current Accepting new patients
Family Health Centers CurrentSince Apr 1, 2016 Accepting new patients
Family Health Centers CurrentSince Apr 1, 2016 Accepting new patients

Locations

525 Jay Ave
Brewster, WA 98812
Phone (509) 689-3455

1003 Koala Dr
Omak, WA 98841
Phone (509) 422-1913

106 S Whitcomb Ave
Tonasket, WA 98855
Phone (509) 486-0114

Interoperability endpoints

  • Direct secure messaging: waldemar.lugo.1@19043.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477440000000",
    "number": "1124152905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1340",
            "city": "OKANOGAN",
            "state": "WA",
            "postal_code": "988401340",
            "telephone_number": "509-422-5700",
            "fax_number": "509-422-7680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 KOALA AVE",
            "city": "OMAK",
            "state": "WA",
            "postal_code": "988419247",
            "telephone_number": "509-422-5700",
            "fax_number": "509-422-7680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUGO-ALVAREZ",
        "first_name": "WALDEMAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2016-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60601420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omak, WA

Sources for this page

Verify at the official NPI Registry.