Individual provider Active NPI

John Lazear Okrent, M.D.

  • Family Medicine Physician
  • Tacoma, WA
National Provider Identifier
1477811263
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60724908 Issued in WA
Practice address
1112 S Cushman Ave
Tacoma, WA 98405-3631
Phone
(253) 593-2144
Fax
(253) 246-6725
NPI assigned
Apr 30, 2012
Last updated
Aug 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD60724908 WA Primary

Addresses

Primary practice location

1112 S Cushman Ave
Tacoma, WA 98405-3631

Mailing address

PO Box 34703
Seattle, WA 98124-1703
Phone (253) 681-6626

Other practice location 1

3544 Jerome Ave
Montefiore Medical Center
Bronx, NY 10467
Phone (718) 920-5521

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
I20170518001621 WA Practitioner - Family Practice 9436452323 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of New York at Buffalo School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sea Mar Community Health CentersGroup PAC ID 7315831161, 235 clinicians

Practice addresses (Care Compare)

1112 S Cushman Ave
Tacoma, WA 98405-3631
Phone (253) 593-2144

7424 Bridgeport Way W
Lakewood, WA 98499-8120
Phone (253) 581-2111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60724908WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sea Mar Community Health Centers Family Medicine CurrentSince Nov 18, 2019 Accepting new patients
Sea Mar Community Health Centers Family Medicine Current Accepting new patients
Sea Mar Community Health Centers CurrentSince Nov 18, 2019 Accepting new patients
Sea-Mar Community Health Center Family Medicine Past Accepting new patients

Locations

1112 S Cushman Ave
Tacoma, WA 98405
Phone (253) 593-2144

7424 Bridgeport Way W
Tacoma, WA 98499
Phone (253) 581-2111

Organizations & group practices 4

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 1

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": "1335744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1477811263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34703",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241703",
            "telephone_number": "253-681-6626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 S CUSHMAN AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984053631",
            "telephone_number": "253-593-2144",
            "fax_number": "253-246-6725"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3544 Jerome Ave",
            "address_2": "Montefiore Medical Center",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "10467",
            "country_code": "US",
            "telephone_number": "718-920-5521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OKRENT",
        "first_name": "JOHN",
        "middle_name": "LAZEAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-30",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60724908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.