Active NPI
Michael John Regalado, M.D.
- Emergency Medicine Physician
- Puyallup, WA
National Provider Identifier
1255368684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- MD00017599
- Practice address
- 407 14TH Ave SE
Puyallup, WA 98372-3770 - Phone
- (253) 848-6661
- Fax
- (253) 770-5990
- NPI assigned
- Jun 28, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | MD00017599 | WA | Primary |
Addresses
Primary practice location
407 14TH Ave SE
Puyallup, WA 98372-3770
Mailing address
PO Box 662050
Arcadia, CA 91066-2050
Phone (626) 447-0296
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8108003 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mt. Rainier Emergency Physicians, PLLC | Emergency Medicine | Past | Accepting new patients |
| Good Samaritan Hospital | Emergency Medicine | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Emergency Medicine Physician
- Puyallup, WA
- NPI 1538104476
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214524800000",
"number": "1255368684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 662050",
"city": "ARCADIA",
"state": "CA",
"postal_code": "910662050",
"telephone_number": "626-447-0296",
"fax_number": "626-447-6057"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "407 14TH AVE SE",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983723770",
"telephone_number": "253-848-6661",
"fax_number": "253-770-5990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REGALADO",
"first_name": "MICHAEL",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-28",
"last_updated": "2008-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "WA",
"license": "MD00017599",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8108003",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Puyallup, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.