Myra Drew Carreon, M.D.

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

MD60672218 Issued in WA

Practice address

1708 Yakima Ave Ste 107
Tacoma, WA 98405-5300

Phone

(253) 207-4850

Fax

(253) 858-5436

NPI assigned

Sep 1, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

NephrologyAlso: Internal Medicine

Education

University of South Florida College of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kaiser Foundation Health Plan of WashingtonGroup PAC ID 9032022579, 1,519 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Puget Sound Kidney Center-Port Orchard Dialysis facility, Port Orchard, WA, CCN 502532

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mcarreon219550@fhsce.catholichealth.net
• Direct secure messaging: mcarreon4264894@ghc.direct-ci.net

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.

• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Seattle, WA
  • NPI 1396810701
  Medicare reassignment Care Compare group NPD
• Pacific Medical Specialty Group

  • Internal Medicine Physician
  • Elma, WA
  • NPI 1548911811
  Medicare reassignment NPD
• Kaiser Foundation Health Plan of Washington

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1386935351
  NPD
• National Kidney Partners, LLP

  • Nephrology Physician
  • Hudson, FL
  • NPI 1780684795
  NPD
• Woodard Creek Healthcare LLC

  • Skilled Nursing Facility
  • Olympia, WA
  • NPI 1740671734
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Puget Sound Kidney Centers

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Port Orchard, WA
  • NPI 1750045860

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1188604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1679767677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 YAKIMA AVE STE 107",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055300",
            "telephone_number": "253-207-4850",
            "fax_number": "253-858-5436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 YAKIMA AVE STE 107",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055300",
            "telephone_number": "253-207-4850",
            "fax_number": "253-858-5436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARREON",
        "first_name": "MYRA",
        "middle_name": "DREW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-01",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME107431",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WA",
            "license": "MD60672218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2072238",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mcarreon219550@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1708 Yakima Ave Ste 107",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984055300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Adelle A Carr, LMT
• David Ellis Carr II
• Abbie Alane Carrasco, REGISTERED NURSE
• Jessica Carratelli, LMHCA
• Amanda Carrell
• Isabella Pia Carreras-Thresher
• Francesca E Carreras-Velez
• Sara Ellen Carrillo, MSW, LICSW,MHP
• Maria Theresa Carrington, LCSW
• Jennifer Carroll

• Nephrology Physician in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Nephrology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.