Active NPI
Megan Brousseau Mahowald, MD
- Family Medicine Physician
- Tacoma, WA
National Provider Identifier
1194141093
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 28709
- Practice address
- 9040 Jackson Ave
Tacoma, WA 98431-1000 - Phone
- (253) 968-1340
- NPI assigned
- Mar 16, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 28709 | NE | Primary |
Addresses
Primary practice location
9040 Jackson Ave
Tacoma, WA 98431-1000
Mailing address
9040A Jackson Ave
Joint Base Lewis McChord, WA 98431-1000
Phone (253) 968-1340
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151012000223 | WA | Order and Referring Only - Family Practice | 7012226103 |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2014
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
4100 International PLZ
Fort Worth, TX 76109-4800
4100 International PLZ
Suite 800
Fort Worth, TX 76109-4839
PO Box
Suite 741571
Los Angeles, CA 90074
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28709 | NE | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1394928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1577318400000",
"number": "1194141093",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9040A JACKSON AVE",
"city": "JOINT BASE LEWIS MCCHORD",
"state": "WA",
"postal_code": "984311000",
"telephone_number": "253-968-1340"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9040 JACKSON AVE",
"city": "TACOMA",
"state": "WA",
"postal_code": "984311000",
"telephone_number": "253-968-1340"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHOWALD",
"first_name": "MEGAN",
"middle_name": "BROUSSEAU",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-03-16",
"last_updated": "2019-12-26",
"certification_date": "2019-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NE",
"license": "28709",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.