Individual provider Active NPI

John Patrick McCloskey, MD

  • Pediatrics Physician
  • Tacoma, WA
National Provider Identifier
1245285501
Registry record updated Oct 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD00022079 Issued in WA
Practice address
603 S J St Ste 102
Tacoma, WA 98405-4100
Phone
(253) 396-4868
Fax
(253) 396-4870
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD00022079 WA Primary

Addresses

Primary practice location

603 S J St Ste 102
Tacoma, WA 98405-4100

Mailing address

603 S J St Ste 102
Tacoma, WA 98405-4100
Phone (253) 396-4868

Other identifiers 1

IdentifierTypeStateIssuer
1041148MedicaidWA

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
I20040517001196 WA Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology)Practitioner - Other (Physician) 7012907421 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of California, San Francisco School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

200 Lilly Rd NE
Suite C
Olympia, WA 98506-5080
Phone (360) 933-0368

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatrix Cardiology of Washington, P.C. CurrentSince Aug 15, 2006 Accepting new patients
Multicare Health System Pediatrics CurrentSince Mar 1, 2025 Accepting new patients
Multicare Health System CurrentSince Mar 1, 2025 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System PastSince Oct 16, 2022 Accepting new patients

Locations

File 50978
Los Angeles, CA 90074

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

200 Lilly Rd NE
Ste C
Olympia, WA 98506
Phone (360) 918-8336

11102 Sunrise Blvd E
Ste 106
Puyallup, WA 98374

400 S 43rd St
Renton, WA 98055
Phone (425) 228-3450

314 Martin Luther King Jr Way
Ste 303
Tacoma, WA 98405

Organizations & group practices 5

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1245285501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 S J ST STE 102",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054100",
            "telephone_number": "253-396-4868",
            "fax_number": "253-396-4870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 S J ST STE 102",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054100",
            "telephone_number": "253-396-4868",
            "fax_number": "253-396-4870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLOSKEY",
        "first_name": "JOHN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00022079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1041148",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.