Individual provider Active NPI

Todd Dwyer Jones, M.D.

  • Otolaryngology Physician
  • Puyallup, WA
National Provider Identifier
1174727010
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD60459916 Issued in WA
Practice address
104 27TH Ave SE
Puyallup, WA 98374-1145
Phone
(253) 770-9000
Fax
(253) 770-9712
NPI assigned
Jun 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 4301111482 MI
Otolaryngology Physician 207Y00000X MD60459916 WA Primary

Addresses

Primary practice location

104 27TH Ave SE
Puyallup, WA 98374-1145

Mailing address

PO Box 1205
Puyallup, WA 98371-0231
Phone (253) 770-9000

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
I20140805001771 WA Practitioner - Otolaryngology 8325275860 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Jefferson Medical College of Thomas Jefferson University, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proliance Surgeons Inc P SGroup PAC ID 8527972900, 395 clinicians

Practice addresses (Care Compare)

104 27TH Ave SE
Puyallup, WA 98374-1145
Phone (425) 775-6651

Hospital & facility affiliations

  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129
  • Multicare Good Samaritan Hospital Hospital, Puyallup, WA, CCN 500079

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301111482MIMDOtolaryngology Physician
MD60459916WAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc PS CurrentSince Feb 13, 2022 Accepting new patients
Proliance Surgeons, Inc., P.S. Otolaryngology CurrentSince Feb 1, 2022 Accepting new patients
Proliance Surgeons Inc P S CurrentSince Feb 1, 2022 Accepting new patients
Proliance Surgeons Inc P S Current Accepting new patients
Proliance Surgeons, Inc., P.S. Otolaryngology Past Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

3801 5th St SE
Ste 110
Puyallup, WA 98374
Phone (253) 845-9585

104 27th Ave SE
Puyallup, WA 98374
Phone (253) 770-4099

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

Interoperability endpoints

  • Direct secure messaging: tjones143526@epic00.shdirect.org

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.

Hospital & facility affiliations 2

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": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1174727010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1205",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983710231",
            "telephone_number": "253-770-9000",
            "fax_number": "253-770-9712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 27TH AVE SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983741145",
            "telephone_number": "253-770-9000",
            "fax_number": "253-770-9712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "TODD",
        "middle_name": "DWYER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-13",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "4301111482",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WA",
            "license": "MD60459916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.