Individual provider Active NPI

Eddie A Espanol, MD

  • Family Medicine Physician
  • Tacoma, WA
National Provider Identifier
1497074314
Registry record updated Sep 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60296602 Issued in WA
Practice address
3124 S 19TH St # 200
Tacoma, WA 98405-2433
Phone
(253) 459-6166
NPI assigned
May 18, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2014

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 MD60296602 WA Primary

Addresses

Primary practice location

3124 S 19TH St # 200
Tacoma, WA 98405-2433

Mailing address

3124 S 19TH St # 200
Tacoma, WA 98405-2433
Phone (253) 459-6166

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
I20130924000928 WA Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 5698919025 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Obstetrics/Gynecology
Education
Oregon Health Sciences University School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

1322 3Rd St SE
Suite 100
Puyallup, WA 98372-3771
Phone (253) 403-7277

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

Hospital & facility affiliations

  • Multicare Good Samaritan Hospital Hospital, Puyallup, WA, CCN 500079

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Oct 8, 2014 Accepting new patients
Swedish Health Services CurrentSince Aug 1, 2013 Accepting new patients
Multicare Health System CurrentSince Oct 8, 2014 Accepting new patients
Multicare Health System Current Accepting new patients
Swedish Health Services Family Medicine Current Accepting new patients
Multicare Health System Past Accepting new patients
Multicare Health System Family Medicine Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

550 16th Ave
Ste 100
Seattle, WA 98122
Phone (206) 299-1900

1101 Madison St
Ste 800
Seattle, WA 98104

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

3124 S 19th St
#200
Tacoma, WA 98405
Phone (253) 459-6166

3124 S 19th St
Tacoma, WA 98405
Phone (253) 301-5050

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Organizations & group practices 7

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.

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": "1274140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1497074314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3124 S 19TH ST # 200",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984052433",
            "telephone_number": "253-459-6166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3124 S 19TH ST # 200",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984052433",
            "telephone_number": "253-459-6166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPANOL",
        "first_name": "EDDIE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-18",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60296602",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.