Active NPI
Robert T Fukura, MD
- Pediatrics Physician
- Seattle, WA
National Provider Identifier
1285653519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD00020376
- Practice address
- 2671 NE 46TH St
Seattle, WA 98105-5041 - Phone
- (206) 585-8000
- Fax
- (206) 525-8070
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD00020376 | WA | Primary |
Addresses
Primary practice location
2671 NE 46TH St
Seattle, WA 98105-5041
Mailing address
1100 9TH Ave
Ms M4-PA
Seattle, WA 98101-2756
Phone (206) 515-5811
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| FU6654 | Other | WA | BLUE SHIELD |
| 3116000 | Other | WA | IDAHO MEDICAID |
| 8626707 | Medicaid | WA | |
| 0039577 | Other | WA | LABOR & INDUSTRY |
| MD673WA | Other | WA | ALASKA MEDICAID |
| US0899939 | Other | WA | AETNA/USHC SPECIALIST |
| US0819029 | Other | WA | AETNA/USHC PCP |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00020376 | WA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1385424000000",
"number": "1285653519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 9TH AVE",
"address_2": "MS M4-PA",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981012756",
"telephone_number": "206-515-5811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2671 NE 46TH ST",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981055041",
"telephone_number": "206-585-8000",
"fax_number": "206-525-8070"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUKURA",
"first_name": "ROBERT",
"middle_name": "T",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2013-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WA",
"license": "MD00020376",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "FU6654",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IDAHO MEDICAID",
"identifier": "3116000",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8626707",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRY",
"identifier": "0039577",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALASKA MEDICAID",
"identifier": "MD673WA",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA/USHC SPECIALIST",
"identifier": "US0899939",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA/USHC PCP",
"identifier": "US0819029",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.