NPIMap

Individual provider Active NPI

Maureen Kimani, MD

  • Family Medicine Physician
  • Puyallup, WA
National Provider Identifier
1396325460
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD61466519 Issued in WA
Practice address
12005 Meridian E Ste 101
Puyallup, WA 98373-3423
Phone
(253) 841-6100
Fax
(253) 841-6139
NPI assigned
Apr 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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 MD61466519 WA Primary

Addresses

Primary practice location

12005 Meridian E Ste 101
Puyallup, WA 98373-3423

Mailing address

12005 Meridian E Ste 101
Puyallup, WA 98373-3423
Phone (253) 841-6100

Other identifiers 1

IdentifierTypeStateIssuer
2180453MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mkimani685883@fhsce.catholichealth.net Direct Franciscan Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241008002126 WA Practitioner - Family Practice 5890199012 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

12005 Meridian E
Suite 101
Puyallup, WA 98373-3423
Phone (253) 215-1095

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.26 of 100Reported as apm
Quality
89.39
Promoting interoperability
85.23
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Family Medicine CurrentSince Sep 1, 2024 Accepting new patients
Franciscan Medical Group CurrentSince Sep 1, 2024 Accepting new patients
Franciscan Medical Group Family Medicine Past Accepting new patients

Locations

4207 Kitsap Way
Bremerton, WA 98312
Phone (360) 415-1080

12005 Meridian E
#101
Puyallup, WA 98373
Phone (253) 215-1095

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

Organizations & group practices 3

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 6

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": "1618185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1396325460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12005 MERIDIAN E STE 101",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733423",
            "telephone_number": "253-841-6100",
            "fax_number": "253-841-6139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12005 MERIDIAN E STE 101",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733423",
            "telephone_number": "253-841-6100",
            "fax_number": "253-841-6139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMANI",
        "first_name": "MAUREEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-12",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61466519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2180453",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mkimani685883@fhsce.catholichealth.net",
            "affiliation": "Y",
            "affiliationName": "Franciscan Medical Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "12005 Meridian E Ste 101",
            "city": "Puyallup",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983733423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.