Organization Active NPI

Lumen Endocrinology PLLC

  • Endocrinology, Diabetes & Metabolism Physician
  • Everett, WA
National Provider Identifier
1548059850
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
LUMEN ENDOCRINOLOGY PLLC
Practice address
10521 19TH Ave SE Ste 100
Everett, WA 98208-4283
Phone
(209) 426-9799
NPI assigned
May 2, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2025

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

Authorized official

Name
Jean Jacques S Nya-Ngatchou, MDNPI 1396076139
Title
Owner
Phone
(209) 426-9799

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X Primary

Addresses

Primary practice location

10521 19TH Ave SE Ste 100
Everett, WA 98208-4283

Mailing address

10521 19TH Ave SE Ste 100
Everett, WA 98208-4283

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250522001573 WA Part B Supplier - Clinic/Group Practice 4688193675 Receives reassigned benefits from 1 practitioner
Practice locations: Everett, WA

National Provider Directory

National Provider Directory

Locations

10521 19th Ave SE
Ste 100
Everett, WA 98208
Phone (425) 533-9777

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1746144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746144000000",
    "number": "1548059850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10521 19TH AVE SE STE 100",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982084283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10521 19TH AVE SE STE 100",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982084283",
            "telephone_number": "209-426-9799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMEN ENDOCRINOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-02",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A",
        "authorized_official_last_name": "NYA-NGATCHOU",
        "authorized_official_first_name": "JEAN JACQUES",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-426-9799",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.