Individual provider Active NPI

Mauricio A Escobar Jr., MD

  • Pediatric Surgery Physician
  • Tacoma, WA
National Provider Identifier
1437389962
Registry record updated Dec 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
MD60067507 Issued in WA
Practice address
311 S L St
Tacoma, WA 98405-3720
Phone
(253) 403-4613
NPI assigned
Jul 17, 2009
Last updated
Dec 6, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD60067507 WA
Pediatric Surgery Physician 2086S0120X MD60067507 WA Primary

Addresses

Primary practice location

311 S L St
Tacoma, WA 98405-3720

Mailing address

311 S L St
Tacoma, WA 98405-3720
Phone (253) 403-4613

Other names 1

  • Tony Escobar Other 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
I20090724000706 WA Practitioner - General SurgeryPractitioner - Pediatric Medicine 5092868943 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60067507WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Aug 21, 2010 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Aug 21, 2010 Accepting new patients
Multicare Health System Past Accepting new patients
Multicare Health System Past Accepting new patients

Locations

200 Lilly Rd NE
Ste C
Olympia, WA 98506
Phone (360) 918-8336

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

317 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 403-1400

Interoperability endpoints

  • Direct secure messaging: mescobarmd7608@direct.multicare.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1247788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323129600000",
    "number": "1437389962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 S L ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984053720",
            "telephone_number": "253-403-4613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 S L ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984053720",
            "telephone_number": "253-403-4613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESCOBAR",
        "first_name": "MAURICIO",
        "middle_name": "A",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-17",
        "last_updated": "2011-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD60067507",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "WA",
            "license": "MD60067507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TONY",
            "last_name": "ESCOBAR",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.