NPIMap

Individual provider Active NPI

Paul B Nutter, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Puyallup, WA
National Provider Identifier
1629020847
Registry record updated Mar 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
MD00021194 Issued in WA
Practice address
401 15TH Ave SE
Puyallup, WA 98372-3715
Phone
(253) 697-2700
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X MD00021194 WA Primary

Addresses

Primary practice location

401 15TH Ave SE
Puyallup, WA 98372-3715

Mailing address

401 15TH Ave SE
Puyallup, WA 98372-3715
Phone (253) 697-2700

Other identifiers 3

IdentifierTypeStateIssuer
1130525MedicaidWA
135919OtherWALABOR & INDUSTRIES
6740NUOtherWAREGENCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, AK2 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
I20100913000498 WA Practitioner - Physical Medicine and Rehabilitation 4880686419 Reassigns benefits to 1 organization
I20230721001591 AK Practitioner - Physical Medicine and Rehabilitation 4880686419 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University of Washington School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services- WashingtonGroup PAC ID 1557408176, 219 clinicians

Practice addresses (Care Compare)

4800 Cordova St
Anchorage, AK 99503-7218
Phone (907) 561-3333

Hospital & facility affiliations

  • Multicare Good Samaritan Hospital Hospital, Puyallup, WA, CCN 500079
  • Providence Alaska Medical Center Hospital, Anchorage, AK, CCN 020001
  • St Elias Specialty Hospital Inpatient rehabilitation facility, Anchorage, AK, CCN 02TA01

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00021194WAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Jun 2, 2014 Accepting new patients
Multicare Health System CurrentSince Jun 2, 2014 Accepting new patients
Providence Health & Services- Washington CurrentSince Jul 15, 2023 Accepting new patients
Multicare Health System Current Accepting new patients

Locations

920 Compassion Cir
Anchorage, AK 99504
Phone (907) 212-9200

4800 Cordova St
Anchorage, AK 99503
Phone (907) 561-3333

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

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

401 15th Ave SE
Puyallup, WA 98372
Phone (253) 697-1848

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

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.

Hospital & facility affiliations 5

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456876800000",
    "number": "1629020847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 15TH AVE SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723715",
            "telephone_number": "253-697-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 15TH AVE SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723715",
            "telephone_number": "253-697-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUTTER",
        "first_name": "PAUL",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2016-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WA",
            "license": "MD00021194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1130525",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "135919",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "6740NU",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.