Individual provider Active NPI

Thu Van Le, MD

  • General Practice Physician
  • Tacoma, WA
National Provider Identifier
1295716884
Registry record updated Mar 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
MD00021181 Issued in WA
Practice address
1212 S 11TH St
Suite 39
Tacoma, WA 98405-4021
Phone
(253) 627-6128
NPI assigned
Nov 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X MD00021181 WA Primary

Addresses

Primary practice location

1212 S 11TH St
Suite 39
Tacoma, WA 98405-4021

Mailing address

1212 S 11TH St
Suite 39
Tacoma, WA 98405-4021
Phone (253) 627-6128

Other identifiers 2

IdentifierTypeStateIssuer
8480097MedicaidWA
1314608MedicaidWA

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

LicenseStateTypeSpecialty
MD00021181WAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thu V. Le, M.D. PastSince Jan 1, 2007 Accepting new patients

Organizations & group practices 1

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": "1131580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205280000000",
    "number": "1295716884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 S 11TH ST",
            "address_2": "SUITE 39",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054021",
            "telephone_number": "253-627-6128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 S 11TH ST",
            "address_2": "SUITE 39",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054021",
            "telephone_number": "253-627-6128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "THU",
        "middle_name": "VAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-10",
        "last_updated": "2008-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WA",
            "license": "MD00021181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8480097",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1314608",
            "state": "WA"
        }
    ],
    "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 Mar 12, 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.

Verify at the official NPI Registry.