Individual provider Active NPI

Melissa Mikiko Chin, MD

  • Hospitalist Physician
  • Tacoma, WA
National Provider Identifier
1760403224
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
MD61076166 Issued in WA
Practice address
1708 Yakima Ave Ste 120
Tacoma, WA 98405-5300
Phone
(253) 596-3696
Fax
(253) 596-3753
NPI assigned
Jul 21, 2006
Last updated
Mar 31, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD16392 RI
Hospitalist Physician 208M00000X MD61076166 WA Primary

Addresses

Primary practice location

1708 Yakima Ave Ste 120
Tacoma, WA 98405-5300

Mailing address

1708 Yakima Ave Ste 120
Tacoma, WA 98405-5300
Phone (253) 596-3696

Other practice location 1

164 Summit Ave
Providence, RI 02906
Phone (401) 793-4489

Other practice location 2

1717 S J St
Tacoma, WA 98405-4933
Phone (253) 426-6970

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050511000268 CA Practitioner - Internal Medicine 3779523527 Reassigns benefits to 4 organizations
I20200921001450 WA Practitioner - Hospitalist 3779523527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hospitalist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

209 Martin Luther King Jr Way
Tacoma, WA 98405-4265
Phone (253) 596-3300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD61076166WAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Jan 29, 2021 Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 29, 2021 Accepting new patients
County of Santa Clara CurrentSince Jul 1, 2006 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Aug 4, 2020 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Aug 4, 2020 Accepting new patients
County of Santa Clara Current Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Jan 29, 2021 Accepting new patients
County of Santa Clara CurrentSince Jul 1, 2006 Accepting new patients

Locations

6041 Cadillac Ave
Los Angeles, CA 90034
Phone (323) 857-2000

10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000

2425 Enborg Ln
San Jose, CA 95128
Phone (408) 885-5400

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

209 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 596-3300

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: mchin527868@ghc.direct-ci.net

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1760403224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 YAKIMA AVE STE 120",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055300",
            "telephone_number": "253-596-3696",
            "fax_number": "253-596-3753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 YAKIMA AVE STE 120",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055300",
            "telephone_number": "253-596-3696",
            "fax_number": "253-596-3753"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "164 Summit Ave",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "02906",
            "country_code": "US",
            "telephone_number": "401-793-4489",
            "fax_number": "401-793-4047",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1717 S J St",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984054933",
            "country_code": "US",
            "telephone_number": "253-426-6970",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHIN",
        "first_name": "MELISSA",
        "middle_name": "MIKIKO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD16392",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WA",
            "license": "MD61076166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1717 S J St",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984054933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.