Individual provider Active NPI

Luis M Taveras, M.D.

  • Family Medicine Physician
  • Puyallup, WA
National Provider Identifier
1447298278
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60994726 Issued in WA
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

Updated by the provider on Apr 8, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
4281OtherFLVA PHARMACY
1447298278MedicaidMO

Other names 1

  • Dr. Luis M Taveras Brossa Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20031217000012 PR Practitioner - Family Practice 3173420239 Practice locations: San Juan, PR
I20101108000151 TX Practitioner - Family Practice 3173420239 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
85.4 of 100Reported as group
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

LicenseStateTypeSpecialty
15060PRMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Nation CurrentSince Nov 13, 2023 Accepting new patients
Southeast Alaska Regional Health Consortium CurrentSince May 18, 2022 Accepting new patients
Arctic Slope Native Association LTD Current Accepting new patients
Maniilaq Association CurrentSince Aug 22, 2018 Accepting new patients
Consolidated Tribal Health Project, Inc. CurrentSince Jul 11, 2022 Accepting new patients
Cherokee Nation Current Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Sep 12, 2010 Accepting new patients
Cherokee Nation Current Accepting new patients
Cherokee Nation Current Accepting new patients
Southeast Alaska Regional Health Consortium CurrentSince May 18, 2022 Accepting new patients
Maniilaq Association CurrentSince Aug 22, 2018 Accepting new patients
Cherokee Nation CurrentSince Nov 13, 2023 Accepting new patients
Cherokee Nation Current Accepting new patients
Fallon Tribal Health Center CurrentSince Dec 9, 2019 Accepting new patients
Choctaw Nation of Oklahoma CurrentSince Sep 12, 2010 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

  • FHIR API: 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.

View all 19

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

Verify at the official NPI Registry.