Active NPI
Luis M Taveras, M.D.
- Family Medicine Physician
- Puyallup, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD60994726
- Practice address
- 10217 125TH Street CT E
Puyallup, WA 98374-2761 - Phone
- (253) 864-4550
- NPI assigned
- Jun 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 15060 | PR | |
| Family Medicine Physician | 207Q00000X | 2010028388 | MO | |
| Spinal Cord Injury Medicine Physician | 2081P0004X | 15060 | PR | |
| Family Medicine Physician | 207Q00000X | MD60994726 | WA | Primary |
Addresses
Primary practice location
10217 125TH Street CT E
Puyallup, WA 98374-2761
Mailing address
3250 Zemke Ave
Tampa, FL 33621-5023
Phone (813) 334-5782
Other practice location 1
530 S Maiden Ln
Joplin, MO 64801-3084
Phone (417) 782-6200
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4281 | Other | FL | VA PHARMACY |
| 1447298278 | Medicaid | MO |
Other names 1
- Dr. Luis M Taveras Brossa
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 85.4 of 100
- Quality
- 72.78
- Promoting interoperability
- 98
- Improvement activities
- 40
- Cost
- 76.77
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15060 | PR | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cherokee Nation | Current | Accepting new patients | |
| Southeast Alaska Regional Health Consortium | Current | Accepting new patients | |
| Arctic Slope Native Association LTD | Current | Accepting new patients | |
| Maniilaq Association | Current | Accepting new patients | |
| Consolidated Tribal Health Project, Inc. | Current | Accepting new patients | |
| Cherokee Nation | Current | Accepting new patients | |
| Choctaw Nation of Oklahoma | Current | Accepting new patients | |
| Cherokee Nation | Current | Accepting new patients | |
| Cherokee Nation | Current | Accepting new patients | |
| Southeast Alaska Regional Health Consortium | Current | Accepting new patients | |
| Maniilaq Association | Current | Accepting new patients | |
| Cherokee Nation | Current | Accepting new patients | |
| Cherokee Nation | Current | Accepting new patients | |
| Fallon Tribal Health Center | Current | Accepting new patients | |
| Choctaw Nation of Oklahoma | Current | Accepting new patients | |
| Southeast Alaska Regional Health Consortium | Current | Accepting new patients | |
| Cherokee Nation | Current | Accepting new patients | |
| Maniilaq Association | Current | Accepting new patients | |
| South East Alaska Regional Health Consortium | Past | Accepting new patients |
Locations
3100 Channel Dr
Ste 300
Juneau, AK 99801
Phone (907) 463-4000
222 Tongass Dr
Sitka, AK 99835
Phone (907) 966-8423
6991 N State St
Redwood Vly, CA 95470
Phone (707) 467-5620
1001 Rio Vista Dr
Fallon, NV 89406
Phone (775) 423-3634
101 S Moore Ave
Claremore, OK 74017
Phone (918) 342-6200
859 E Melton Dr
Jay, OK 74346
Phone (918) 253-4271
1127 S George Nigh Expy
McAlester, OK 74501
Phone (800) 349-7026
1001 S 41st St E
Muskogee, OK 74403
Phone (918) 687-0201
1001 S 41st St E
#3
Muskogee, OK 74403
Phone (918) 687-0201
1020 Lenape Dr
Nowata, OK 74048
Phone (918) 273-0192
395200 W 2900 Rd
Ochelata, OK 74051
Phone (918) 535-6000
900 N Owen Walters Blvd
Salina, OK 74365
Phone (918) 434-8500
821 Amohi Ln
Salina, OK 74365
Phone (918) 434-8500
301 S J T Stites St
Sallisaw, OK 74955
Phone (918) 774-1400
100 S Bliss Ave
Tahlequah, OK 74464
Phone (918) 458-3100
1 Choctaw Way
Talihina, OK 74571
Phone (918) 423-8440
Dept 2269
Tulsa, OK 74182
27371 S 4410 Rd
Vinita, OK 74301
Phone (918) 256-4800
Interoperability endpoints
- https://api.platform.athenahealth.com/15156/brand/1/csg/1/fhir/r4
Organizations & group practices 19
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.
-
- Critical Access Hospital
- Barrow, AK
- NPI 1306933643
-
- Public Health or Welfare Agency
- Tahlequah, OK
- NPI 1013884154
-
- Multi-Specialty Clinic/Center
- Salina, OK
- NPI 1326054081
-
- Multi-Specialty Clinic/Center
- Vinita, OK
- NPI 1558377226
-
- Multi-Specialty Clinic/Center
- Muskogee, OK
- NPI 1841207156
-
- Multi-Specialty Clinic/Center
- Nowata, OK
- NPI 1891703716
-
- Multi-Specialty Clinic/Center
- Stilwell, OK
- NPI 1992711345
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712534400000",
"number": "1447298278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3250 ZEMKE AVE",
"city": "TAMPA",
"state": "FL",
"postal_code": "336215023",
"telephone_number": "813-334-5782"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10217 125TH STREET CT E",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983742761",
"telephone_number": "253-864-4550"
}
],
"practiceLocations": [
{
"address_1": "530 S Maiden Ln",
"address_purpose": "LOCATION",
"city": "Joplin",
"state": "MO",
"postal_code": "648013084",
"country_code": "US",
"telephone_number": "417-782-6200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TAVERAS",
"first_name": "LUIS",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-03",
"last_updated": "2024-04-08",
"certification_date": "2024-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PR",
"license": "15060",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MO",
"license": "2010028388",
"primary": false
},
{
"code": "2081P0004X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine",
"state": "PR",
"license": "15060",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "MD60994726",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VA PHARMACY",
"identifier": "4281",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1447298278",
"state": "MO"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LUIS",
"last_name": "TAVERAS BROSSA",
"middle_name": "M",
"prefix": "DR.",
"credential": "M.D.",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Puyallup, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.