Individual provider Active NPI

Elijah Burbank

  • Anesthesiology Physician
  • Tacoma, WA
National Provider Identifier
1295083731
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD61066706 Issued in WA
Practice address
1717 S J St
Tacoma, WA 98405-4933
Phone
(253) 426-4101
NPI assigned
Aug 15, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X MD61066706 WA Primary

Addresses

Primary practice location

1717 S J St
Tacoma, WA 98405-4933

Mailing address

20920 SE 216TH Way
Maple Valley, WA 98038-6454
Phone (253) 441-1981

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
I20200810001757 WA Practitioner - Anesthesiology 6901175496 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Washington School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rainier Anesthesia Associates PCGroup PAC ID 4284523499, 69 clinicians

Practice addresses (Care Compare)

407 14TH Ave SE
Puyallup, WA 98372-3770
Phone (253) 848-6661

Hospital & facility affiliations

  • Multicare Good Samaritan Hospital Hospital, Puyallup, WA, CCN 500079
  • Multicare Auburn Medical Center Hospital, Auburn, WA, CCN 500015
  • Multicare Covington Medical Center Hospital, Covington, WA, CCN 500154
  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rainier Anesthesia Associates PC Single Specialty CurrentSince Dec 1, 2022 Accepting new patients
Pacific Anesthesia PC Single Specialty CurrentSince Jul 17, 2020 Accepting new patients

Locations

11808 Northup Way
Ste W300
Bellevue, WA 98005
Phone (425) 284-1545

17700 SE 272nd St
Kent, WA 98042
Phone (253) 372-6500

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

104 27th Ave SE
Puyallup, WA 98374
Phone (253) 770-4099

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1344988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1295083731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20920 SE 216TH WAY",
            "city": "MAPLE VALLEY",
            "state": "WA",
            "postal_code": "980386454",
            "telephone_number": "253-441-1981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 S J ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054933",
            "telephone_number": "253-426-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURBANK",
        "first_name": "ELIJAH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-15",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "MD61066706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.