Active NPI
Madeleine Prat, M.D.
- Internal Medicine Physician
- Tacoma, WA
National Provider Identifier
1649652157
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 19654
- Practice address
- 9040 Jackson Ave
Tacoma, WA 98431-0001 - Phone
- (253) 968-1110
- NPI assigned
- Jun 19, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | 19654 | HI | Primary |
Addresses
Primary practice location
9040 Jackson Ave
Tacoma, WA 98431-0001
Mailing address
9040 Jackson Ave
Tacoma, WA 98431-0001
Other practice location 1
1 Jarrett White Rd
Tripler Army Medical Center, HI 96859-5001
Phone (808) 433-4049
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in HI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190925000156 | HI | Practitioner - Hospitalist | 9133474083 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19654 | HI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hawaii Permanente Medical Group Inc | Current | Accepting new patients |
Locations
711 Kapiolani Blvd
Honolulu, HI 96813
Phone (808) 432-5312
3288 Moanalua Rd
Honolulu, HI 96819
Phone (808) 265-9205
Organizations & group practices 1
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": "1434672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624233600000",
"number": "1649652157",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9040 JACKSON AVE",
"city": "TACOMA",
"state": "WA",
"postal_code": "984310001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9040 JACKSON AVE",
"city": "TACOMA",
"state": "WA",
"postal_code": "984310001",
"telephone_number": "253-968-1110"
}
],
"practiceLocations": [
{
"address_1": "1 Jarrett White Rd",
"address_purpose": "LOCATION",
"city": "Tripler Army Medical Center",
"state": "HI",
"postal_code": "968595001",
"country_code": "US",
"telephone_number": "808-433-4049",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PRAT",
"first_name": "MADELEINE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-19",
"last_updated": "2021-06-21",
"certification_date": "2021-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "HI",
"license": "19654",
"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 Jun 21, 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.