Active NPI
Lyudmila Ivanovna Petruk, MD
- Neurology Physician
- Tacoma, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- MD00046499
- Practice address
- 209 Martin Luther King Jr Way
Tacoma, WA 98405-4265 - Phone
- (253) 596-3410
- NPI assigned
- Oct 5, 2006
- Last updated
- Mar 24, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Neuromusculoskeletal Medicine) Physician | 204C00000X | MD27033 | OR | |
| Neurology Physician | 2084N0400X | 4215 | WI | |
| Neurology Physician | 2084N0400X | 21092 | NV | |
| Neurology Physician | 2084N0400X | MD00046499 | WA | Primary |
| Neurology Physician | 2084N0400X | 76532 | MN |
Addresses
Primary practice location
209 Martin Luther King Jr Way
Tacoma, WA 98405-4265
Mailing address
209 Martin Luther King Jr Way
Tacoma, WA 98405-4265
Phone (253) 596-3300
Other practice location 1
1608 S J St Fl 5
Tacoma, WA 98405-4930
Phone (253) 274-7505
Other practice location 2
535 Hospital Rd
New Richmond, WI 54017-1449
Phone (715) 243-3400
Other practice location 3
834 Sheridan St
Port Townsend, WA 98368-2443
Phone (360) 774-8125
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MD27033 | Other | OR | MEDICAL LICENSE |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync | Health Information Exchange (HIE) | |
| Direct Messaging Address | lpetruk891152@fhsce.catholichealth.net | Direct | Franciscan Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA, NV, MN, WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 4
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- University of Washington School of Medicine, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1608 S J St
FL 5
Tacoma, WA 98405-4930
Phone (253) 274-7505
265 Griffin E St
Amery, WI 54001-1439
Phone (715) 268-8000
265 Griffin St E
Amery, WI 54001-1439
Phone (715) 268-8000
535 Hospital Rd
New Richmond, WI 54017-1449
Phone (715) 243-2600
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 76532 | MN | MD | Neurology Physician |
| MD00046499 | WA | MD | Neurology Physician |
| 4215 | WI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carson Tahoe Physician Clinics | Current | Accepting new patients | |
| Franciscan Medical Group | Current | Accepting new patients | |
| Amery Regional Medical Center, Inc. | Current | Accepting new patients | |
| Franciscan Medical Group | Current | Accepting new patients | |
| CTH Physicians Clinic | Current | Accepting new patients | |
| Franciscan Medical Group | Current | Accepting new patients | |
| Amery Regional Medical Center, Inc. | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| Multicare Health System | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| Group Health, Inc. | Current | Accepting new patients | |
| Westfields Hospital, Inc | Current | Accepting new patients | |
| Multicare Health System | Current | Accepting new patients | |
| Virginia Mason Medical Center | Current | Accepting new patients | |
| Multicare Health System | Current | Accepting new patients | |
| Group Health, Inc. | Current | Accepting new patients | |
| Virginia Mason Medical Center | Current | Accepting new patients | |
| Virginia Mason Medical Center | Current | Accepting new patients | |
| Amery Regional Medical Center, Inc. | Current | Accepting new patients | |
| Westfields Hospital, Inc. | Current | Accepting new patients | |
| Group Health, Inc. | Current | Accepting new patients | |
| Westfields Hospital, Inc. | Past | Accepting new patients | |
| Amery Regional Medical Center, Inc. | Past | Accepting new patients | |
| West Physician Services LLC | Past | Accepting new patients |
Locations
8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375
8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600
1500 Curve Crest Blvd W
Stillwater, MN 55082
1470 Medical Pkwy
Ste 160
Carson City, NV 89703
1600 Medical Pkwy
Carson City, NV 89703
Phone (775) 220-9149
2874 N Carson St
Ste 200
Carson City, NV 89706
Phone (775) 283-3220
570 S Maine St
Fallon, NV 89406
Phone (775) 423-9511
380 Winslow Way E
Bainbridge Island, WA 98110
Phone (206) 842-5632
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
1100 9th Ave
Seattle, WA 98101
Phone (206) 223-6980
200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530
925 Seneca St
Seattle, WA 98101
Phone (206) 341-0860
1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200
209 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 596-3300
315 S K St
Tacoma, WA 98405
Phone (253) 403-1291
9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800
265 Griffin St E
Amery, WI 54001
Phone (715) 268-0301
411 Stageline Rd
#200
Hudson, WI 54016
Phone (715) 531-6700
535 Hospital Rd
New Richmond, WI 54017
Phone (651) 292-2013
744 E Louisiana St
St Croix Fls, WI 54024
Phone (651) 772-6251
Interoperability endpoints
- lpetruk891152@fhsce.catholichealth.net
Organizations & group practices 25
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.
-
dba Franciscan Orthopedics-Silverdale
- Orthopaedic Surgery Physician
- Silverdale, WA
- NPI 1093165334
-
dba Amery Hospital & Clinic
- Critical Access Hospital
- Amery, WI
- NPI 1093763518
-
dba Westfields Hospital
- Critical Access Hospital
- New Richmond, WI
- NPI 1881640183
-
- Multi-Specialty Clinic/Center
- Seattle, WA
- NPI 1396810701
-
dba Multicare Neurological Surgery
- Neurological Surgery Physician
- Tacoma, WA
- NPI 1497766638
-
- General Acute Care Hospital
- Seattle, WA
- NPI 1801851258
-
- Internal Medicine Physician
- Carson City, NV
- NPI 1023265717
-
dba HealthPartners Medical Group
- Multi-Specialty Clinic/Center
- Minneapolis, MN
- NPI 1710924683
WI
-
dba Jefferson Healthcare
- Critical Access Hospital
- Port Townsend, WA
- NPI 1356492953
-
dba Harrison HealthPartners, A Part of the Franciscan Medical Group
- Internal Medicine Physician
- Bremerton, WA
- NPI 1154564649
-
- Family Medicine Physician
- Tacoma, WA
- NPI 1366539421
-
dba Everett Medical Center
- Multi-Specialty Clinic/Center
- Everett, WA
- NPI 1386935351
Hospital & facility affiliations 19
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba St Joseph Lab PAC LAB
- Clinical Medical Laboratory
- Tacoma, WA
- NPI 1659585370
Hospital
-
dba St Joseph Medical Center
- General Acute Care Hospital
- Tacoma, WA
- NPI 1952309098
-
dba St Joseph Medical Center
- General Acute Care Hospital
- Tacoma, WA
- NPI 1124291117
-
dba Jefferson Healthcare Swingbed
- Medicare Defined Swing Bed Hospital Unit
- Port Townsend, WA
- NPI 1104950039
-
dba Jefferson Healthcare
- Critical Access Hospital
- Port Townsend, WA
- NPI 1356492953
-
dba Sleep Medicine, Jefferson Healthcare
- Sleep Medicine (Psychiatry & Neurology) Physician
- Silverdale, WA
- NPI 1467664631
Hospital
-
dba Amery Hospital & Clinic
- Critical Access Hospital
- Amery, WI
- NPI 1093763518
-
dba Amery Hospital & Clinic -Clear Lake Clinic
- Rural Health Clinic/Center
- Clear Lake, WI
- NPI 1366878449
Hospital
-
dba Turtle Lake Clinic
- Rural Health Clinic/Center
- Turtle Lake, WI
- NPI 1538384466
Hospital
-
dba Amery Hospital & Clinic - Luck
- Rural Health Clinic/Center
- Luck, WI
- NPI 1851345268
Hospital
-
dba HealthPartners Specialty Center Woodbury
- General Acute Care Hospital
- Woodbury, MN
- NPI 1104681105
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774310400000",
"number": "1528154770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 MARTIN LUTHER KING JR WAY",
"city": "TACOMA",
"state": "WA",
"postal_code": "984054265",
"telephone_number": "253-596-3300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "209 MARTIN LUTHER KING JR WAY",
"city": "TACOMA",
"state": "WA",
"postal_code": "984054265",
"telephone_number": "253-596-3410"
}
],
"practiceLocations": [
{
"address_1": "1608 S J St Fl 5",
"address_purpose": "LOCATION",
"city": "Tacoma",
"state": "WA",
"postal_code": "984054930",
"country_code": "US",
"telephone_number": "253-274-7505",
"fax_number": "253-985-2853",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "535 Hospital Rd",
"address_purpose": "LOCATION",
"city": "New Richmond",
"state": "WI",
"postal_code": "540171449",
"country_code": "US",
"telephone_number": "715-243-3400",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "834 Sheridan St",
"address_purpose": "LOCATION",
"city": "Port Townsend",
"state": "WA",
"postal_code": "983682443",
"country_code": "US",
"telephone_number": "360-774-8125",
"fax_number": "360-774-8127",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PETRUK",
"first_name": "LYUDMILA",
"middle_name": "IVANOVNA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-05",
"last_updated": "2026-03-24",
"certification_date": "2026-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "204C00000X",
"taxonomy_group": "",
"desc": "Neuromusculoskeletal Medicine, Sports Medicine",
"state": "OR",
"license": "MD27033",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "WI",
"license": "4215",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "NV",
"license": "21092",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "WA",
"license": "MD00046499",
"primary": true
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "MN",
"license": "76532",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "MD27033",
"state": "OR"
}
],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "209 Martin Luther King Jr Way",
"city": "Tacoma",
"state": "WA",
"country_code": "US",
"postal_code": "984054265",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lpetruk891152@fhsce.catholichealth.net",
"affiliation": "Y",
"affiliationName": "Franciscan Medical Group",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1608 S J St Fl 5",
"city": "Tacoma",
"state": "WA",
"country_code": "US",
"postal_code": "984054930",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.