Individual provider Active NPI

Joan C Tsang, MD

  • Pediatrics Physician
  • Bonney Lake, WA
National Provider Identifier
1376500793
Registry record updated Apr 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
60587855 Issued in WA
Practice address
9230 Sky Island Dr E
Bonney Lake, WA 98391-7385
Phone
(253) 750-6000
Fax
(253) 750-6100
NPI assigned
Apr 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 60587855 WA Primary

Addresses

Primary practice location

9230 Sky Island Dr E
Bonney Lake, WA 98391-7385

Mailing address

9230 Sky Island Dr E
Bonney Lake, WA 98391-7385
Phone (253) 750-6000

Other identifiers 2

IdentifierTypeStateIssuer
100373060KMedicaidKS
003719209OtherMEDICARE

Other names 1

  • Joan Chung Ki Lau Former name

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
I20160114002581 WA Practitioner - Pediatric Medicine 8123059938 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60587855WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Pediatrics CurrentSince Jan 11, 2016 Accepting new patients
Franciscan Medical Group CurrentSince Jan 11, 2016 Accepting new patients
Franciscan Medical Group Current Accepting new patients
Franciscan Health System Past Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

21 NE Romance Hill Rd
Ste 105
Belfair, WA 98528
Phone (360) 277-2950

9230 Sky Island Dr E
Bonney Lake, WA 98391
Phone (253) 750-6000

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Organizations & group practices 5

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": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492128000000",
    "number": "1376500793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9230 SKY ISLAND DR E",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983917385",
            "telephone_number": "253-750-6000",
            "fax_number": "253-750-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9230 SKY ISLAND DR E",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983917385",
            "telephone_number": "253-750-6000",
            "fax_number": "253-750-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSANG",
        "first_name": "JOAN",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-28",
        "last_updated": "2017-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "60587855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100373060K",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "003719209",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOAN",
            "last_name": "LAU",
            "middle_name": "CHUNG KI",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bonney Lake, WA

Sources for this page

Verify at the official NPI Registry.