Active NPI
Luis Lozano, PA
- Surgical Physician Assistant
- Puyallup, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- PA1003732
- Practice address
- 3801 5TH St SE Ste 110
Puyallup, WA 98374-2106 - Phone
- (253) 845-9585
- Fax
- (253) 848-1126
- NPI assigned
- Jan 6, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA1003732 | WA | |
| Surgical Physician Assistant | 363AS0400X | PA1003732 | WA | Primary |
Addresses
Primary practice location
3801 5TH St SE Ste 110
Puyallup, WA 98374-2106
Mailing address
3801 5TH St SE Ste 110
Puyallup, WA 98374-2106
Phone (253) 845-9585
Other practice location 1
20920 Sr 410 E
Bonney Lake, WA 98391-6302
Phone (253) 845-9585
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500518 | Other | WA | WA LABOR & INDUSTRIES |
| 2025150 | Medicaid | WA |
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3801 5TH St SE
Puyallup, WA 98374-2106
Hospital & facility affiliations
- Multicare Good Samaritan Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA1003732 | WA | MD | Surgical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cascade Surgery Associates, PLLC | Current | Accepting new patients | |
| Proliance Surgeons Inc P S | Surgical | Current | Accepting new patients |
| Proliance Surgeons, Inc., P.S. | Current | Accepting new patients | |
| Washington Gastroenterology PLLC | Past | Accepting new patients |
Locations
122 3rd St NE
Auburn, WA 98002
Phone (253) 833-7750
20920 State Route 410 E
Bonney Lake, WA 98391
Phone (253) 845-9585
17700 SE 272nd St
Ste 420
Kent, WA 98042
Phone (253) 639-9660
17700 SE 272nd St
#420
Kent, WA 98042
Phone (253) 639-9660
3801 5th St SE
Ste 110
Puyallup, WA 98374
Phone (253) 845-9585
4011 Talbot Rd S
Ste 300
Renton, WA 98055
Phone (206) 656-5060
805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100
Interoperability endpoints
- luis.lozano.p83@direct.proliance.nextgenshare.com
Organizations & group practices 5
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.
-
- Orthopaedic Surgery Physician
- Seattle, WA
- NPI 1023170313
-
- Specialist
- Bonney Lake, WA
- NPI 1558327601
-
- Otolaryngology Physician
- Puyallup, WA
- NPI 1407223985
-
- Gastroenterology Physician
- Tacoma, WA
- NPI 1306364401
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Puyallup, WA
- NPI 1841231461
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136505600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1731283200000",
"number": "1720066947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3801 5TH ST SE STE 110",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983742106",
"telephone_number": "253-845-9585",
"fax_number": "253-848-1126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3801 5TH ST SE STE 110",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983742106",
"telephone_number": "253-845-9585",
"fax_number": "253-848-1126"
}
],
"practiceLocations": [
{
"address_1": "20920 SR 410 E",
"address_purpose": "LOCATION",
"city": "Bonney Lake",
"state": "WA",
"postal_code": "983916302",
"country_code": "US",
"telephone_number": "253-845-9585",
"fax_number": "253-848-1126",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LOZANO",
"first_name": "LUIS",
"name_prefix": "Mr.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-06",
"last_updated": "2024-11-11",
"certification_date": "2024-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WA",
"license": "PA1003732",
"primary": false
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "WA",
"license": "PA1003732",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WA LABOR & INDUSTRIES",
"identifier": "500518",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2025150",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Puyallup, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; 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.