Individual provider Active NPI

Iris Maria Tio-Matos, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Tacoma, WA
National Provider Identifier
1508887647
Registry record updated Nov 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
31306 Issued in WA
Practice address
Pshcs American Lake Division
A-111-PC
Tacoma, WA 98493-5000
Phone
(253) 582-8440
Fax
(253) 589-4150
NPI assigned
Jul 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 31306 WA Primary

Addresses

Primary practice location

Pshcs American Lake Division
A-111-PC
Tacoma, WA 98493-5000

Mailing address

9600 Veterans Drive a-111-R
American Lake VA
Tacoma, WA 98493-0001
Phone (253) 582-8440

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
I20110613000342 WA Order and Referring Only - Geriatric MedicinePractitioner - Geriatric Medicine 0143407528

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
31306WAMDGeriatric Medicine (Internal Medicine) Physician

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194220800000",
    "number": "1508887647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9600 VETERANS DRIVE A-111-R",
            "address_2": "AMERICAN LAKE VA",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984930001",
            "telephone_number": "253-582-8440",
            "fax_number": "253-589-4150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PSHCS AMERICAN LAKE DIVISION",
            "address_2": "A-111-PC",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984935000",
            "telephone_number": "253-582-8440",
            "fax_number": "253-589-4150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIO-MATOS",
        "first_name": "IRIS",
        "middle_name": "MARIA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-22",
        "last_updated": "2007-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "WA",
            "license": "31306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.