Maria Socorro Miranda Gandara, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP60909533 Issued in WA

Practice address

1100 Eastside St SE
Olympia, WA 98501-7304

Phone

(360) 943-5127

Fax

(360) 754-2516

NPI assigned

Dec 7, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mso Washington IncGroup PAC ID 1850292681, 14 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Tacoma, WA, CCN 507031
• Signature Healthcare at Home Home health agency, Federal Way, WA, CCN 507110
• Puget Sound Home Health Home health agency, Tacoma, WA, CCN 507101
• Assured Home Health Home health agency, Mountlake Terrace, WA, CCN 507099
• CHI Franciscan Health at Home Home health agency, University Place, WA, CCN 507124

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: maria.gandara@589522414665732.direct.elationemr.com
• Direct secure messaging: maria.gandara.1@2876.direct.athenahealth.com

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.

• Mso Washington, Inc.

  • Family Medicine Physician
  • Lakewood, WA
  • NPI 1891116109

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Capital Medical Center Physicians LLC

  • Family Medicine Physician
  • Olympia, WA
  • NPI 1629214283
  Medicare reassignment NPD
• Multicare Health System

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638
  Medicare reassignment NPD
• Capital Medical Center Physicians LLC

  • Internal Medicine Physician
  • Montesano, WA
  • NPI 1710744792
  NPD
• Multicare Health System

  • Family Medicine Physician
  • Auburn, WA
  • NPI 1013969195

  Nurse Practitioner

  NPD
• Multicare Health System

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD

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

• Centerwell Certified Healthcare Corp.

  • Home Health Agency
  • Tacoma, WA
  • NPI 1801825187
  Care Compare affiliation
• CHI National Home Care, LLC

  • Home Health Agency
  • University Place, WA
  • NPI 1972919249
  Care Compare affiliation
• LHCG Lxiii, LLC

  • Home Health Agency
  • Mountlake Terrace, WA
  • NPI 1770998528
  Care Compare affiliation
• Maritime Healthcare LLC

  • Home Health Agency
  • Federal Way, WA
  • NPI 1518701168
  Care Compare affiliation
• Symbol Healthcare, Inc.

  • Home Health Agency
  • Tacoma, WA
  • NPI 1912242678
  Care Compare affiliation

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

{
    "created_epoch": "1196985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1366625717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CAPITAL EASTSIDE FAMILY PRACTICE",
            "address_2": "1100 EASTSIDE ST SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "98501",
            "telephone_number": "360-943-5127",
            "fax_number": "360-754-2516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 EASTSIDE ST SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985017304",
            "telephone_number": "360-943-5127",
            "fax_number": "360-754-2516"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1802 S J Street",
            "address_2": "Suite 120",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984054965",
            "country_code": "US",
            "telephone_number": "253-428-2200",
            "fax_number": "253-428-2299",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Madigan Army Medical Ctr",
            "address_2": "9040 Jackson Ave",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984310001",
            "country_code": "US",
            "telephone_number": "253-968-3869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANDARA",
        "first_name": "MARIA SOCORRO",
        "middle_name": "MIRANDA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-07",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60231010",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60909533",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60909533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2112470",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgandara244360@fhsce.catholichealth.net",
            "affiliation": "Y",
            "affiliationName": "Franciscan Medical Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1802 S J Street",
            "address_2": "Suite 120",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984054965",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mellissa M Gallegos
• Andrea Gallo
• Christine Keller Galvin, MA
• Christopher Steven Galvin, L.M.P
• Kerry L Gamble, FNP
• Shaleena Ganie
• Karin Kristine Ganz, M.A., LMHC
• Kathleen Garber, MA, LMHC
• Abelardo Leon Garcia Kuri
• Amy Lee Garcia

• Family Nurse Practitioner in Olympia, WA
• Providers in Olympia, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.