Individual provider Active NPI

Taimur Ikram

  • Family Nurse Practitioner
  • Lakewood, WA
National Provider Identifier
1437832565
Registry record updated Aug 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2023019467 Issued in WA
Practice address
4901 108TH St SW
Lakewood, WA 98499-3724
Phone
(253) 584-3577
Fax
(253) 984-1079
NPI assigned
Aug 7, 2023
Last updated
Aug 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2023019467 WA Primary

Addresses

Primary practice location

4901 108TH St SW
Lakewood, WA 98499-3724

Mailing address

PO Box 98745
Lakewood, WA 98496-8745
Phone (253) 584-3577

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230918004117 WA Practitioner - Nurse Practitioner 4284098633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mso Washington IncGroup PAC ID 1850292681, 14 clinicians

Practice addresses (Care Compare)

33400 8TH Ave S
Suite 232
Federal Way, WA 98003-6382
Phone (253) 584-3577

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2023019467WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mso Washington, Inc. CurrentSince Aug 1, 2023 Accepting new patients

Locations

33400 8th Ave S
Ste 232
Federal Way, WA 98003

4901 108th St SW
Tacoma, WA 98499
Phone (253) 584-3577

4903 108th St SW
Tacoma, WA 98499
Phone (253) 584-3577

Interoperability endpoints

  • Direct secure messaging: taimur.ikram@589522414665732.direct.elationemr.com

Organizations & group practices 1

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 5

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": "1691366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1437832565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98745",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984968745",
            "telephone_number": "253-584-3577",
            "fax_number": "253-984-1079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 108TH ST SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993724",
            "telephone_number": "253-584-3577",
            "fax_number": "253-984-1079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IKRAM",
        "first_name": "TAIMUR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-07",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "2023019467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

Verify at the official NPI Registry.