Individual provider Active NPI

Jovita C. D'Souza, NP-C

  • Family Nurse Practitioner
  • Arlington, WA
National Provider Identifier
1174074017
Registry record updated Oct 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP60703572 Issued in WA
Practice address
3823 172ND St NE
Arlington, WA 98223-7735
Phone
(360) 428-2500
Fax
(360) 428-6470
NPI assigned
Oct 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN60110523 WA
Family Nurse Practitioner 363LF0000X AP60703572 WA Primary

Addresses

Primary practice location

3823 172ND St NE
Arlington, WA 98223-7735

Mailing address

1400 E Kincaid St
Mount Vernon, WA 98274-4127
Phone (360) 814-7575

Other practice location 1

22850 NE 8th St Ste 103
Sammamish, WA 98074-7275
Phone (425) 898-0305

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jdsouza32950@skagit.direct-ci.com Direct

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
I20170419001092 WA Practitioner - Nurse Practitioner 0345526794 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No 2 Current Accepting new patients
Public Hospital Dist No 1 Skagit Current Accepting new patients
Providence Health & Services Washington CurrentSince Jan 17, 2023 Accepting new patients
King County Public Hospital District No. 2 CurrentSince Apr 5, 2017 Accepting new patients
King County Public Hospital District No. 2 Current Accepting new patients
Public Hospital Dist No 1 Skagit CurrentSince Jan 4, 2021 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
Public Hospital District No 2 CurrentSince Apr 5, 2017 Accepting new patients
Public Hospital Dist No 1 Skagit CurrentSince Jan 4, 2021 Accepting new patients

Locations

3823 172nd St NE
Arlington, WA 98223
Phone (360) 618-5000

1909 214th St SE
Ste 110
Bothell, WA 98021
Phone (425) 488-4988

14720 Main St NE
Ste 109
Duvall, WA 98019
Phone (425) 788-4889

12039 NE 128th St
Ste 300
Kirkland, WA 98034
Phone (425) 899-3123

12040 NE 128th St
#10
Kirkland, WA 98034
Phone (206) 466-0369

1400 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 428-2586

1620 Cooper Point Rd SW
Olympia, WA 98502
Phone (360) 486-6710

525 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8550

Interoperability endpoints

  • Direct secure messaging: jdsouza32950@skagit.direct-ci.com

Organizations & group practices 9

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": "1476489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635120000000",
    "number": "1174074017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E KINCAID ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744127",
            "telephone_number": "360-814-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3823 172ND ST NE",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982237735",
            "telephone_number": "360-428-2500",
            "fax_number": "360-428-6470"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22850 NE 8th St Ste 103",
            "address_purpose": "LOCATION",
            "city": "Sammamish",
            "state": "WA",
            "postal_code": "980747275",
            "country_code": "US",
            "telephone_number": "425-898-0305",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "D'SOUZA",
        "first_name": "JOVITA",
        "middle_name": "C.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-15",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60110523",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60703572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdsouza32950@skagit.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "Provider Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3823 172nd St NE",
            "city": "Arlington",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982237735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Arlington, WA

Sources for this page

Verify at the official NPI Registry.