Individual provider Active NPI

Talia Ruth Firestein, MD

  • Family Medicine Physician
  • Antioch, CA
National Provider Identifier
1184966707
Registry record updated Aug 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60572762 Issued in WA
Practice address
2335 Country Hills Dr
Antioch, CA 94509
Phone
(925) 608-8550
Fax
(925) 608-8559
NPI assigned
Mar 21, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A141785 CA
Family Medicine Physician 207Q00000X MD60572762 WA Primary

Addresses

Primary practice location

2335 Country Hills Dr
Antioch, CA 94509

Mailing address

5216 Point Fosdick Dr # 102
Gig Harbor, WA 98335-0037
Phone (253) 530-6900

Other practice location 1

5216 Point Fosdick Dr # 102
Gig Harbor, WA 98335-0037
Phone (253) 530-6900

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync Health Information Exchange (HIE)

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
I20210809003270 WA Practitioner - Family Practice 0749506525 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Warren Alpert Medical School of Brown University, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1400 Pottery Ave
Port Orchard, WA 98366-3711
Phone (360) 895-5000

209 Martin Luther King Jr Way
Tacoma, WA 98405-4265
Phone (253) 596-3300

9505 S Steele St
Tacoma, WA 98444-1858
Phone (253) 597-6800

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A141785CAMDFamily Medicine Physician
MD60572762WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington Family Medicine CurrentSince Aug 8, 2021 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Jul 2, 2021 Accepting new patients
Kaiser Foundation Health Plan of Washington Family Medicine CurrentSince Jul 2, 2021 Accepting new patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients

Locations

5216 Point Fosdick Dr
#102
Gig Harbor, WA 98335
Phone (253) 530-6900

125 16th Ave E
#545
Seattle, WA 98112
Phone (206) 326-3530

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: tfirestein136274@ghc.direct-ci.net

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": "1363824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627862400000",
    "number": "1184966707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5216 POINT FOSDICK DR # 102",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983350037",
            "telephone_number": "253-530-6900",
            "fax_number": "253-530-6901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2335 COUNTRY HILLS DR",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "94509",
            "telephone_number": "925-608-8550",
            "fax_number": "925-608-8559"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5216 Point Fosdick Dr # 102",
            "address_purpose": "LOCATION",
            "city": "Gig Harbor",
            "state": "WA",
            "postal_code": "983350037",
            "country_code": "US",
            "telephone_number": "253-530-6900",
            "fax_number": "253-530-6901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FIRESTEIN",
        "first_name": "TALIA",
        "middle_name": "RUTH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-21",
        "last_updated": "2021-08-02",
        "certification_date": "2021-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A141785",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60572762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "5216 Point Fosdick Dr # 102",
            "city": "Gig Harbor",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983350037",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Antioch, CA

Sources for this page

Verify at the official NPI Registry.