Individual provider Active NPI

Jeremiah V Ojeaburu, M.D.

  • Gastroenterology Physician
  • Puyallup, WA
National Provider Identifier
1306810023
Registry record updated Jun 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD00041002 Issued in WA
Practice address
11216 Sunrise Blvd E Ste 3-207
Puyallup, WA 98374-8848
Phone
(253) 272-8148
NPI assigned
Feb 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD00041002 WA Primary

Addresses

Primary practice location

11216 Sunrise Blvd E Ste 3-207
Puyallup, WA 98374-8848

Mailing address

11216 Sunrise Blvd E Ste 3-207
Puyallup, WA 98374-8848

Other identifiers 2

IdentifierTypeStateIssuer
8327157MedicaidWA
MD00041002OtherWAWA LICENSE

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
I20101202000628 WA Practitioner - Gastroenterology 4688711716 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Washington Gastroenterology PLLCGroup PAC ID 6204194848, 142 clinicians

Practice addresses (Care Compare)

1703 S Meridian
Suite 305
Puyallup, WA 98371-7590
Phone (253) 841-3933

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy73
Upper gastrointestinal (GI) endoscopy for acid reflux59

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Gastroenterology PLLC CurrentSince Dec 15, 2017 Accepting new patients
Washington Gastroenterology PLLC CurrentSince Dec 15, 2017 Accepting new patients
Washington Gastroenterology PLLC Gastroenterology Current Accepting new patients
Western Washington Endoscopy Centers LLC Past Accepting new patients

Locations

33915 1st Way S
Ste 200
Federal Way, WA 98003
Phone (253) 838-9839

17700 SE 272nd St
#420
Kent, WA 98042
Phone (253) 639-9660

17700 SE 272nd St
Ste 420
Kent, WA 98042
Phone (253) 639-9660

11216 Sunrise Blvd E
Ste 201
Puyallup, WA 98374
Phone (253) 435-7050

11216 Sunrise Blvd E
Ste 3207
Puyallup, WA 98374
Phone (253) 770-3700

1703 S Meridian
Ste 305
Puyallup, WA 98371
Phone (253) 841-3933

1703 S Meridian
Ste 203
Puyallup, WA 98371
Phone (253) 841-3933

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

11216 Sunrise Blvd E
Ste 3-201
Puyallup, WA 98374
Phone (253) 770-3700

11216 Sunrise Blvd E
Ste 3-207
Puyallup, WA 98374

1446 Spaulding Ave
Richland, WA 99352
Phone (509) 420-4588

1901 S Union Ave
Ste B4006
Tacoma, WA 98405
Phone (253) 383-8342

2202 S Cedar St
Ste 330
Tacoma, WA 98405
Phone (253) 503-2547

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561075200000",
    "number": "1306810023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11216 SUNRISE BLVD E STE 3-207",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983748848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11216 SUNRISE BLVD E STE 3-207",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983748848",
            "telephone_number": "253-272-8148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OJEABURU",
        "first_name": "JEREMIAH",
        "middle_name": "V",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2019-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WA",
            "license": "MD00041002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8327157",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA LICENSE",
            "identifier": "MD00041002",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.