Active NPI
Titus Koipaton Sairo, FNP-C
- Family Nurse Practitioner
- Tacoma, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 61004280
- Practice address
- 1201 Pacific Ave Ste 400
Tacoma, WA 98402-4381 - Phone
- (253) 300-8453
- NPI assigned
- Nov 2, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP131522 | TX | |
| Family Nurse Practitioner | 363LF0000X | RN188920 | GA | |
| Family Nurse Practitioner | 363LF0000X | 61004280 | WA | Primary |
Addresses
Primary practice location
1201 Pacific Ave Ste 400
Tacoma, WA 98402-4381
Mailing address
315 Boulevard NE Ste 310
Atlanta, GA 30312-1264
Phone (678) 371-8222
Other practice location 1
315 Boulevard NE Ste 310
Atlanta, GA 30312-1264
Phone (678) 371-8222
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: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN188920 | GA | MD | Family Nurse Practitioner |
| AP131522 | TX | MD | Family Nurse Practitioner |
| 61004280 | WA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Molina Healthcare of Washington, Inc | Current | Accepting new patients | |
| Molina Healthcare of Washington, Inc | Current | Accepting new patients | |
| SHC Medical Center Toppenish | Current | Accepting new patients | |
| Sunnyside Community Hospital Association | Family | Current | Accepting new patients |
| Sunnyside Community Hospital Association | Current | Accepting new patients | |
| Sunnyside Community Hospital Association | Current | Accepting new patients | |
| SHC Medical Center Toppenish | Current | Accepting new patients |
Locations
200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666
15 SW Everett Mall Way
Ste A
Everett, WA 98204
Phone (425) 348-6727
222 E 2nd St
Grandview, WA 98930
Phone (509) 203-6501
355 Chardonnay Ave
Prosser, WA 99350
Phone (509) 781-6366
2705 E Lincoln Ave
Sunnyside, WA 98944
Phone (509) 836-4848
2925 Allen Rd
Sunnyside, WA 98944
Phone (509) 837-4949
502 W 4th Ave
Toppenish, WA 98948
Phone (509) 575-5000
1420 Ahtanum Ridge Dr
Union Gap, WA 98903
Phone (509) 454-7700
110 S 9th Ave
Yakima, WA 98902
Phone (509) 575-5000
1005 W Walnut St
Ste 120
Yakima, WA 98902
Phone (509) 248-6080
Interoperability endpoints
- tsairo12407@direct-prd.molinahealthcare.com
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.
-
- Family Medicine Physician
- Everett, WA
- NPI 1912235060
-
- General Acute Care Hospital
- Toppenish, WA
- NPI 1851817308
-
- Rural Health Clinic/Center
- Sunnyside, WA
- NPI 1679521637
-
- Family Medicine Physician
- Bothell, WA
- NPI 1659897163
-
- Rural Health Clinic/Center
- Zillah, WA
- NPI 1659809457
-
- Rural Health Clinic/Center
- Sunnyside, WA
- NPI 1407289184
Family
-
- Anesthesiology Physician
- Yakima, WA
- NPI 1609395045
-
- Clinic/Center
- Yakima, WA
- NPI 1609395060
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611014400000",
"number": "1528510898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "315 BOULEVARD NE STE 310",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303121264",
"telephone_number": "678-371-8222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 PACIFIC AVE STE 400",
"city": "TACOMA",
"state": "WA",
"postal_code": "984024381",
"telephone_number": "253-300-8453"
}
],
"practiceLocations": [
{
"address_1": "315 Boulevard NE Ste 310",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "303121264",
"country_code": "US",
"telephone_number": "678-371-8222",
"fax_number": "678-705-2378",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SAIRO",
"first_name": "TITUS",
"middle_name": "KOIPATON",
"name_prefix": "Mr.",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-11-02",
"last_updated": "2021-01-19",
"certification_date": "2021-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "TX",
"license": "AP131522",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "GA",
"license": "RN188920",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WA",
"license": "61004280",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"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 Jan 19, 2021; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.