Individual provider Active NPI

Efren Rebusit Caratao Jr., M.D.

  • General Practice Physician
  • Kent, WA
National Provider Identifier
1366502601
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
MD00028063 Issued in WA
Practice address
10413 SE 244TH St
Kent, WA 98030-4961
Phone
(253) 852-2770
Fax
(253) 852-6770
NPI assigned
Dec 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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 MD00028063 WA Primary

Addresses

Primary practice location

10413 SE 244TH St
Kent, WA 98030-4961

Mailing address

10413 SE 244TH St
Kent, WA 98030-4961
Phone (253) 852-2770

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
I20040527000001 WA Practitioner - General Practice 8426039264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Easthill Medical Clinic LLCGroup PAC ID 4284958018, 2 clinicians

Practice addresses (Care Compare)

10413 SE 244TH St
Kent, WA 98030-4961
Phone (253) 852-2770

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00028063WAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Easthill Medical Clinic LLC CurrentSince Dec 1, 2014 Accepting new patients
East Hill Medical Clinic General Practice Past Accepting new patients

Locations

10413 SE 244th St
Kent, WA 98030
Phone (253) 852-2770

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.

NPI Registry JSON

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

{
    "created_epoch": "1165622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1366502601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10413 SE 244TH ST",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980304961",
            "telephone_number": "253-852-2770",
            "fax_number": "253-852-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10413 SE 244TH ST",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980304961",
            "telephone_number": "253-852-2770",
            "fax_number": "253-852-6770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARATAO",
        "first_name": "EFREN",
        "middle_name": "REBUSIT",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-09",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WA",
            "license": "MD00028063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, WA

Sources for this page

Verify at the official NPI Registry.