Individual provider Active NPI

Jeffrey Stephen Newman, M.D., PHD

  • Procedural Dermatology Physician
  • Puyallup, WA
National Provider Identifier
1528032919
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Procedural Dermatology PhysicianTaxonomy code 207NS0135X
License
MD00047170 Issued in WA
Practice address
2622 S Meridian
Puyallup, WA 98373-1500
Phone
(253) 841-2453
Fax
(253) 840-5519
NPI assigned
Feb 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD00047170 WA
Procedural Dermatology Physician 207NS0135X MD00047170 WA Primary

Addresses

Primary practice location

2622 S Meridian
Puyallup, WA 98373-1500

Mailing address

2622 S Meridian
Puyallup, WA 98373-1500
Phone (253) 841-2453

Other identifiers 6

IdentifierTypeStateIssuer
8475642MedicaidWA
P00443871OtherRR MEDICARE
53030 GROUPOtherWAL&I
7095656 GROUPMedicaidWA
CS6844 GROUPOtherRR MEDICARE
217912OtherWAL&I

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
I20070827000188 WA Practitioner - Dermatology 4880697887 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Albert Einstein College of Medicine of Yeshiva University, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Puyallup Dermatology Clinic Inc P.S.Group PAC ID 1153313408, 5 clinicians

Practice addresses (Care Compare)

2622 S Meridian
Puyallup, WA 98373-1500
Phone (253) 841-2453

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision27
Removal of skin lesions119
Removal of skin cancer249
Skin biopsy55

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00047170WAMDDermatology Physician

Organizations & group practices 1

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": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1528032919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2622 S MERIDIAN",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983731500",
            "telephone_number": "253-841-2453",
            "fax_number": "253-840-5519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2622 S MERIDIAN",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983731500",
            "telephone_number": "253-841-2453",
            "fax_number": "253-840-5519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWMAN",
        "first_name": "JEFFREY",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "M.D., PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD00047170",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "WA",
            "license": "MD00047170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8475642",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00443871",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "53030  GROUP",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7095656  GROUP",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CS6844  GROUP",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "217912",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.