Active NPI
Brian L McDonald, MD
- Internal Medicine Physician
- Federal Way, WA
National Provider Identifier
1710906110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD00016800
- Practice address
- 33501 1St Way S
Federal Way, WA 98003-6208 - Phone
- (253) 838-2400
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD00016800 | WA | Primary |
Addresses
Primary practice location
33501 1St Way S
Federal Way, WA 98003-6208
Mailing address
1100 9TH Ave
Ms:M4-PA
Seattle, WA 98101-2756
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MD6896W | Other | WA | ALASKA MEDICAID |
| US0899633 | Other | WA | AETNA/USHC PCP |
| 0039581 | Other | WA | LABOR & INDUSTRY |
| 1615905 | Medicaid | WA | |
| M331 | Other | WA | BLUE SHIELD |
| 110089488 | Other | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00016800 | WA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213660800000",
"number": "1710906110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 9TH AVE",
"address_2": "MS:M4-PA",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981012756"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33501 1ST WAY S",
"city": "FEDERAL WAY",
"state": "WA",
"postal_code": "980036208",
"telephone_number": "253-838-2400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONALD",
"first_name": "BRIAN",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2008-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WA",
"license": "MD00016800",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALASKA MEDICAID",
"identifier": "MD6896W",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA/USHC PCP",
"identifier": "US0899633",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRY",
"identifier": "0039581",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1615905",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "M331",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "110089488",
"state": null
}
],
"endpoints": [],
"other_names": []
}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 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.