Organization Active NPI

Franciscan Medical Group

Doing business as St. Franciscan Rheumatology Clinic

  • Rheumatology Physician
  • Federal Way, WA
National Provider Identifier
1669502639
Registry record updated Jun 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
Legal business name
FRANCISCAN MEDICAL GROUP
Doing business as
St. Franciscan Rheumatology Clinic
Practice address
34509 9TH Ave S
Suite #202
Federal Way, WA 98003-6700
Phone
(253) 838-3045
Fax
(253) 838-3310
NPI assigned
Mar 7, 2007
Organization subpart
Yes
Parent organization
FRANCISCAN MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 14, 2010

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

Authorized official

Name
Cliff Robertson, MD
Title
Chief Medical Officer
Phone
(253) 779-6101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RR0500X Primary

Addresses

Primary practice location

34509 9TH Ave S
Suite #202
Federal Way, WA 98003-6700

Mailing address

34509 9TH Ave S
Suite #202
Federal Way, WA 98003-6700
Phone (253) 838-3045

Other identifiers 1

IdentifierTypeStateIssuer
7136815MedicaidWA

Other names 1

  • St. Franciscan Rheumatology Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031111000789 WA Part B Supplier - Clinic/Group Practice 0547173866 Receives reassigned benefits from 1,720 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Part of
Franciscan Medical Grou

Locations

34509 9th Ave S
Ste 202
Federal Way, WA 98003
Phone (253) 942-2270

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276473600000",
    "number": "1669502639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34509 9TH AVE S",
            "address_2": "SUITE #202",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036700",
            "telephone_number": "253-838-3045",
            "fax_number": "253-838-3310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34509 9TH AVE S",
            "address_2": "SUITE #202",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036700",
            "telephone_number": "253-838-3045",
            "fax_number": "253-838-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANCISCAN MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRANCISCAN MEDICAL GROUP",
        "enumeration_date": "2007-03-07",
        "last_updated": "2010-06-14",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "CLIFF",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "253-779-6101",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7136815",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Franciscan Rheumatology Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2010; 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.