NPIMap

Individual provider Active NPI

Justin Brana Pavlovich, M.D.

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Tacoma, WA
National Provider Identifier
1528238805
Registry record updated May 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X
License
MD61656857 Issued in WA
Practice address
1608 S J St FL 5
Tacoma, WA 98405-4930
Phone
(253) 274-7505
Fax
(253) 274-7948
NPI assigned
Mar 3, 2008
Last updated
May 1, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 29320 OR
Otolaryngology Physician 207Y00000X MD61656857 WA
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X MD61656857 WA Primary

Addresses

Primary practice location

1608 S J St FL 5
Tacoma, WA 98405-4930

Mailing address

1608 S J St FL 5
Tacoma, WA 98405-4930
Phone (253) 274-7505

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jpavlovich1719@direct.theportlandclinic.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100510000527 OR Practitioner - Otolaryngology 7810025046 Reassigns benefits to 1 organization
I20250513002623 WA Practitioner - OtolaryngologyPractitioner - Other (Physician) 7810025046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Pittsburgh School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

1608 S J St
FL 5
Tacoma, WA 98405-4930
Phone (253) 274-7505

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29320ORMDOtolaryngology Physician
MD61656857WAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Portland Clinic Laboratory Current Accepting new patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group CurrentSince Apr 14, 2025 Accepting new patients
Franciscan Medical Group CurrentSince Apr 14, 2025 Accepting new patients
Portland Clinic Past Accepting new patients

Locations

800 SW 13th Ave
Portland, OR 97205
Phone (503) 221-0161

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Interoperability endpoints

  • Direct secure messaging: jpavlovich1719@direct.theportlandclinic.net

Organizations & group practices 6

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.

Hospital & facility affiliations 9

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": "1204502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1528238805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 S J ST FL 5",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054930",
            "telephone_number": "253-274-7505",
            "fax_number": "253-274-7948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 S J ST FL 5",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054930",
            "telephone_number": "253-274-7505",
            "fax_number": "253-274-7948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVLOVICH",
        "first_name": "JUSTIN",
        "middle_name": "BRANA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-03",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OR",
            "license": "29320",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WA",
            "license": "MD61656857",
            "primary": false
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "WA",
            "license": "MD61656857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jpavlovich1719@direct.theportlandclinic.net",
            "affiliation": "N",
            "address_1": "9250 SW Hall Blvd",
            "city": "Tigard",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972236857",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.