Individual provider Active NPI

Muhammad Ayub, MD

  • Family Medicine Physician
  • Tacoma, WA
National Provider Identifier
1386641694
Registry record updated Nov 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00044810 Issued in WA
Practice address
9040 Jackson Ave Madigan Army Medical Center
Tacoma, WA 98431-0001
Phone
(253) 968-5779
Fax
(253) 968-1678
NPI assigned
Jun 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00044810 WA Primary

Addresses

Primary practice location

9040 Jackson Ave Madigan Army Medical Center
Tacoma, WA 98431-0001

Mailing address

9040 Fitzsimmons Drive
Madigan Army Medical Center
Fort Lewis, WA 98431
Phone (253) 968-5779

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
I20050601001035 WA Practitioner - Family Practice 0648212530 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
South Sound Inpatient Physicians PLLC Family Medicine CurrentSince Mar 22, 2014 Accepting new patients
South Sound Inpatient Physicians PLLC Family Medicine Current Accepting new patients
Sea Mar Community Health Centers CurrentSince Aug 24, 2013 Accepting new patients
Sea Mar Community Health Centers Family Medicine CurrentSince Aug 24, 2013 Accepting new patients
Grays Harbor Community Hospital Current Accepting new patients
Grays Harbor Community Hospital CurrentSince May 1, 2016 Accepting new patients
South Sound Inpatient Physicians PLLC CurrentSince Mar 22, 2014 Accepting new patients
Grays Harbor Community Hospital CurrentSince May 1, 2016 Accepting new patients
Sea Mar Community Health Centers Family Medicine Current Accepting new patients

Locations

915 Anderson Dr
Aberdeen, WA 98520
Phone (360) 532-8330

16251 Sylvester Rd SW
Burien, WA 98166
Phone (206) 244-9970

3030 Limited Ln NW
Olympia, WA 98502
Phone (360) 352-6000

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

820 NW 95th St
Seattle, WA 98117
Phone (206) 781-6800

Organizations & group practices 9

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": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1386641694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 FITZSIMMONS DRIVE",
            "address_2": "MADIGAN ARMY MEDICAL CENTER",
            "city": "FORT LEWIS",
            "state": "WA",
            "postal_code": "98431",
            "telephone_number": "253-968-5779",
            "fax_number": "253-968-1678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE MADIGAN ARMY MEDICAL CENTER",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-5779",
            "fax_number": "253-968-1678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYUB",
        "first_name": "MUHAMMAD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00044810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.