Mujalin Thuntarug, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA.60512148 Issued in WA

Practice address

14212 Ambaum Blvd SW
Suite 106
Burien, WA 98166-1449

Phone

(206) 244-5520

Fax

(206) 957-0034

NPI assigned

Jan 12, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Peacehealth Networks on Demand LLCGroup PAC ID 1759731383, 197 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/30646/brand/1/csg/1/fhir/r4
• Direct secure messaging: mujalin.thuntarug.1@30646.direct.athenahealth.com

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.

• Peacehealth Networks on Demand, LLC

  • General Practice Physician
  • Tigard, OR
  • NPI 1023582178

  WA

  Medicare reassignment Care Compare group
• Cynthia L. Taylor, MD

  • Family Medicine Physician
  • Burien, WA
  • NPI 1083648877
  NPD (past)
• Zoomcare PC

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1689647372
  NPD (past)
• Zoomcare Urgent Care LLC

  • Urgent Care Clinic/Center
  • Lake Oswego, OR
  • NPI 1376225813
  NPD (past)

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

{
    "created_epoch": "1421020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421020800000",
    "number": "1750770905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14212 AMBAUM BLVD SW",
            "address_2": "SUITE 106",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981661449",
            "telephone_number": "206-244-5520",
            "fax_number": "206-957-0034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14212 AMBAUM BLVD SW",
            "address_2": "SUITE 106",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981661449",
            "telephone_number": "206-244-5520",
            "fax_number": "206-957-0034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THUNTARUG",
        "first_name": "MUJALIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-12",
        "last_updated": "2015-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA.60512148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly D Thompson, MSN, ARNP
• Three Tree Women'S Clinic, PLLC
• Three Trees Pediatric Occupational Therapy
• Thrifty Payless Inc
• Ashley Xavier Thundiyil
• Ladonya S Ticeson
• Meghan M Tierney, MD
• Barbara Ann Timeus, RN
• Maitai Tiumalu
• Dandrell Toaston

• Medical Physician Assistant in Burien, WA
• Providers in Burien, WA by specialty
• Medical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2015; 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.