Mia Danielle Debarros, MD

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

MD60666886 Issued in WA

Practice address

9040 Jackson Avenue
Joint Base Lewis McChord, WA 98431-1000

Phone

(253) 968-2200

NPI assigned

Jan 29, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 4

Electronic endpoints 1

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

Specialty

Thoracic SurgeryAlso: General Surgery

Education

Boston University School of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Services WashingtonGroup PAC ID 6709782600, 480 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St Peter Hospital Hospital, Olympia, WA, CCN 500024
• Providence Centralia Hospital Hospital, Centralia, WA, CCN 500019
• Summit Pacific Medical Center Hospital, Elma, WA, CCN 501304

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mdebarros41748@fhsce.catholichealth.net

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.

• Providence Health & Services Washington

  • Family Medicine Physician
  • Olympia, WA
  • NPI 1174744304
  Medicare reassignment Care Compare group NPD
• Franciscan Medical Group

  • Family Medicine Physician
  • Gig Harbor, WA
  • NPI 1386602555
  NPD (past)
• Providence Health & Services Washington

  • General Acute Care Hospital
  • Olympia, WA
  • NPI 1346250594
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Grays Harbor County Public Hospital District No 1

  • Critical Access Hospital
  • Elma, WA
  • NPI 1740211028
  Care Compare affiliation
• Providence Health & Services Washington

  • General Acute Care Hospital
  • Olympia, WA
  • NPI 1346250594
  Care Compare affiliation
• Providence Health & Services Washington

  • General Acute Care Hospital
  • Centralia, WA
  • NPI 1376624981
  Care Compare affiliation
• Providence Health & Services Washington

  • General Acute Care Hospital
  • Olympia, WA
  • NPI 1619176997
  Care Compare affiliation

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

{
    "created_epoch": "1264723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700784000000",
    "number": "1467783597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVENUE",
            "city": "JOINT BASE LEWIS MCCHORD",
            "state": "WA",
            "postal_code": "984311000",
            "telephone_number": "253-968-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVENUE",
            "city": "JOINT BASE LEWIS MCCHORD",
            "state": "WA",
            "postal_code": "984311000",
            "telephone_number": "253-968-2200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1802 Yakima Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984055303",
            "country_code": "US",
            "telephone_number": "253-272-7777",
            "fax_number": "253-426-4142",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1950 NW Myhre Rd Fl 3",
            "address_purpose": "LOCATION",
            "city": "Silverdale",
            "state": "WA",
            "postal_code": "983837662",
            "country_code": "US",
            "telephone_number": "564-240-4200",
            "fax_number": "564-240-4299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEBARROS",
        "first_name": "MIA",
        "middle_name": "DANIELLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-29",
        "last_updated": "2023-11-24",
        "certification_date": "2023-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD60666886",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NE",
            "license": "26423",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "WA",
            "license": "MD60666886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2033450",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "26423",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "278192",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "60666886",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdebarros41748@fhsce.catholichealth.net",
            "affiliation": "Y",
            "affiliationName": "Franciscan Medical Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1802 Yakima Ave Ste 102",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984055303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kimberly Dang, PA-C
• Porsha Daniele
• Jasmine T Daniels, MD
• Megan Elizabeth Darby
• Alexander Dassoff
• Susan Elane Delozierhooks, PA
• Jordan Demay
• Megan M Derazin
• Bethany A Deschamps, RD
• Ryne Maddox Deyoe, DO

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Joint Base Lewis McChord, WA
• Providers in Joint Base Lewis McChord, WA by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2023; 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.

Verify at the official NPI Registry.