Individual provider Active NPI

Mai Nitta

  • Pediatrics Physician
  • Covington, WA
National Provider Identifier
1578940425
Registry record updated Jul 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD60850526 Issued in WA
Practice address
17700 SE 272ND St # 440
Covington, WA 98042-4951
Phone
(253) 372-7155
NPI assigned
Apr 29, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD60850526 WA Primary

Addresses

Primary practice location

17700 SE 272ND St # 440
Covington, WA 98042-4951

Mailing address

P.O. Box 5299
Ms: 1313-5-Pco
Tacoma, WA 98415-0299

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180710000817 WA Practitioner - Pediatric Medicine 2961758768 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60850526WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Jul 31, 2021 Accepting new patients
Multicare Health System CurrentSince Jul 31, 2021 Accepting new patients
Multicare Health System PastSince Jul 10, 2022 Accepting new patients

Locations

17700 SE 272nd St
Ste 460
Covington, WA 98042
Phone (253) 403-0077

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

17700 SE 272nd St
Ste 440
Kent, WA 98042

17700 SE 272nd St
#460
Kent, WA 98042

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

17700 SE 272nd St
#440
Kent, WA 98042
Phone (253) 372-7155

Organizations & group practices 4

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": "1430265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1578940425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 5299",
            "address_2": "MS: 1313-5-PCO",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984150299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17700 SE 272ND ST # 440",
            "city": "COVINGTON",
            "state": "WA",
            "postal_code": "980424951",
            "telephone_number": "253-372-7155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NITTA",
        "first_name": "MAI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-29",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD60850526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, WA

Sources for this page

Verify at the official NPI Registry.