Individual provider Active NPI

Vincent Nnaemeka Muoneke, MD

  • Plastic and Reconstructive Surgery Physician
  • Burien, WA
National Provider Identifier
1699712448
Registry record updated Apr 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
MD00027931 Issued in WA
Practice address
16233 Sylvester Rd SW
Suite280
Burien, WA 98166-3045
Phone
(206) 248-6992
Fax
(253) 984-6774
NPI assigned
Jun 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X MD00027931 WA Primary

Addresses

Primary practice location

16233 Sylvester Rd SW
Suite280
Burien, WA 98166-3045

Mailing address

PO Box 97115
Lakewood, WA 98497-0115
Phone (253) 588-7911

Other identifiers 3

IdentifierTypeStateIssuer
0103941OtherWALABOR & INDUSTRY
1094879MedicaidWA
MU7229OtherWAREGENCE

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
I20151001001262 WA Practitioner - Plastic and Reconstructive Surgery 8325050206 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Robert Marriott Medical Corp Plastic and Reconstructive Surgery CurrentSince Jul 1, 2020 Accepting new patients

Locations

222 N Pacific Coast Hwy
Ste 2175
El Segundo, CA 90245
Phone (877) 850-8762

12509 Greenwood Ave N
Seattle, WA 98133
Phone (206) 361-1989

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239580800000",
    "number": "1699712448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 97115",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984970115",
            "telephone_number": "253-588-7911",
            "fax_number": "253-984-6774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16233 SYLVESTER RD SW",
            "address_2": "SUITE280",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981663045",
            "telephone_number": "206-248-6992",
            "fax_number": "253-984-6774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUONEKE",
        "first_name": "VINCENT",
        "middle_name": "NNAEMEKA",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2009-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "WA",
            "license": "MD00027931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRY",
            "identifier": "0103941",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1094879",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "MU7229",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burien, WA

Sources for this page

Verify at the official NPI Registry.