Individual provider Active NPI

Juan David Parra Valencia, MD

  • Surgery Physician
  • Pullman, WA
National Provider Identifier
1679585111
Registry record updated Sep 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ML20007834 Issued in WA
Practice address
825 SE Bishop Blvd
Suite 130
Pullman, WA 99163-5517
Phone
(206) 890-7354
NPI assigned
Aug 13, 2006
Last updated
Sep 1, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X ML20007834 WA Primary

Addresses

Primary practice location

825 SE Bishop Blvd
Suite 130
Pullman, WA 99163-5517

Mailing address

825 SE Bishop Blvd
Suite 130
Pullman, WA 99163-5517
Phone (206) 890-7354

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
I20090728000589 WA Practitioner - General Surgery 0749333441 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1200 W Fairview St
Colfax, WA 99111-9552
Phone (509) 397-3435

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ML20007834WAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital District No 3 of Whitman County CurrentSince Dec 28, 2022 Accepting new patients
Whitman Medical Group PS Past Accepting new patients

Locations

1200 W Fairview St
Colfax, WA 99111
Phone (509) 397-3435

Interoperability endpoints

  • Direct secure messaging: jparra326350@wm.providencedirect.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314835200000",
    "number": "1679585111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 SE BISHOP BLVD",
            "address_2": "SUITE 130",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635517",
            "telephone_number": "206-890-7354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 SE BISHOP BLVD",
            "address_2": "SUITE 130",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635517",
            "telephone_number": "206-890-7354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARRA VALENCIA",
        "first_name": "JUAN",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2011-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "ML20007834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pullman, WA

Sources for this page

Verify at the official NPI Registry.