Individual provider Active NPI

Julian Coronas

  • Chiropractor
  • Des Moines, WA
National Provider Identifier
1558076455
Registry record updated Jan 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH61374257 Issued in WA
Practice address
23100 Pacific Hwy S
Des Moines, WA 98198-7281
Phone
(206) 466-4721
NPI assigned
Jan 16, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH61374257 WA Primary

Addresses

Primary practice location

23100 Pacific Hwy S
Des Moines, WA 98198-7281

Mailing address

23100 Pacific Hwy S
Des Moines, WA 98198-7281

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240214000883 WA Practitioner - Chiropractic 2163866518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midway Healthcare Therapeutics LLCGroup PAC ID 9638154826, 5 clinicians

Practice addresses (Care Compare)

14410 SE Petrovitsky Rd
Suite 109
Renton, WA 98058-8900
Phone (425) 226-1856

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Midway Healthcare Therapeutics LLC Chiropractor CurrentSince Jan 1, 2024 Accepting new patients
Midway Healthcare Therapeutics LLC Chiropractor Current Accepting new patients

Locations

23100 Pacific Hwy S
Ste 201
Des Moines, WA 98198
Phone (206) 824-9500

14410 SE Petrovitsky Rd
Ste 109
Renton, WA 98058
Phone (425) 226-0327

Organizations & group practices 2

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": "1673827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673827200000",
    "number": "1558076455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23100 PACIFIC HWY S",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981987281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23100 PACIFIC HWY S",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981987281",
            "telephone_number": "206-466-4721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORONAS",
        "first_name": "JULIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-16",
        "last_updated": "2023-01-16",
        "certification_date": "2023-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH61374257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.