Individual provider Active NPI

Neil R Hannigan, MD

  • Nephrology Physician
  • Tacoma, WA
National Provider Identifier
1508893090
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD00041237 Issued in WA
Practice address
9040 Jackson Avenue
Tacoma, WA 98431-2028
Phone
(253) 968-1485
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MD00041237 WA Primary

Addresses

Primary practice location

9040 Jackson Avenue
Tacoma, WA 98431-2028

Mailing address

Madigan Army Medical Center, Nephrology Services
9040 Jackson Ave
Tacoma, WA 98431
Phone (253) 968-1485

Other identifiers 2

IdentifierTypeStateIssuer
1116557MedicaidWA
0242914MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicoxy.et0764.epichosted.com/FHIRProxy/api/FHIR/Rpr4/

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
I20040204000348 WA Practitioner - NephrologyPractitioner - Geriatric Medicine 2062305055 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00041237WAMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Medical Group-Renton Internal Medicine CurrentSince Sep 1, 2022 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Jun 7, 2022 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Jun 7, 2022 Accepting new patients
Multicare Health System CurrentSince Jan 23, 2017 Accepting new patients
Multicare Health System CurrentSince Jan 23, 2017 Accepting new patients
Multicare Health System Current Accepting new patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients
Evergreen Nephrology Associates PLLC Past Accepting new patients

Locations

16850 SE 272nd St
Ste 100
Covington, WA 98042
Phone (253) 395-1971

4545 Point Fosdick Dr
Ste 250
Gig Harbor, WA 98335
Phone (253) 267-5755

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

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

24920 104th Ave SE
Kent, WA 98030
Phone (253) 395-1985

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

10452 Silverdale Way NW
Silverdale, WA 98383
Phone (360) 307-7300

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

1901 S Union Ave
Ste B7011
Tacoma, WA 98405
Phone (253) 627-5755

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

Interoperability endpoints

  • Direct secure messaging: nhanniganmd5611@direct.multicare.org
  • Direct secure messaging: nhannigan99586@direct.valleymed.org

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756425600000",
    "number": "1508893090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MADIGAN ARMY MEDICAL CENTER, NEPHROLOGY SERVICES",
            "address_2": "9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98431",
            "telephone_number": "253-968-1485",
            "fax_number": "253-968-1188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVENUE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984312028",
            "telephone_number": "253-968-1485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNIGAN",
        "first_name": "NEIL",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WA",
            "license": "MD00041237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1116557",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0242914",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicoxy.et0764.epichosted.com/FHIRProxy/api/FHIR/Rpr4/",
            "affiliation": "N",
            "address_1": "820 N Chelan Ave",
            "city": "Wenatchee",
            "state": "WA",
            "country_code": "US",
            "postal_code": "988012028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.