NPIMap

Individual provider Active NPI

Rommel Monillas Enriquez, M.D.

  • Internal Medicine Physician
  • Olympia, WA
National Provider Identifier
1780843060
Registry record updated Nov 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD60284880 Issued in WA
Practice address
413 Lilly Rd NE
Olympia, WA 98506-5133
Phone
(360) 493-4069
NPI assigned
Jun 3, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2012

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 13462 NV
Internal Medicine Physician 207R00000X MD60284880 WA Primary

Addresses

Primary practice location

413 Lilly Rd NE
Olympia, WA 98506-5133

Mailing address

413 Lilly Rd NE
Olympia, WA 98506-5133
Phone (360) 493-4069

Other identifiers 1

IdentifierTypeStateIssuer
MD60284880OtherWASTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121130000225 WA Practitioner - HospitalistPractitioner - Internal Medicine 2365597093 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

413 Lilly Rd NE
Olympia, WA 98506-5133
Phone (360) 493-4083

525 Lilly Rd NE
Olympia, WA 98506-5101

700 Lilly Rd NE
Olympia, WA 98506-5115
Phone (360) 923-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13462NVMDInternal Medicine Physician
MD60284880WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Jul 30, 2013 Accepting new patients
Hospitalist Healthcare Services PLLC Internal Medicine Past Accepting new patients
Usacs Integrated Acute Care Services of Nevada Bagnoli P C Past Accepting new patients
Stephen Holtzclaw MD PC Reno Past Accepting new patients
Providence Health & Services Washington Past Accepting new patients

Locations

413 Lilly Rd NE
Olympia, WA 98506
Phone (360) 491-9480

700 Lilly Rd NE
Olympia, WA 98506
Phone (360) 923-7000

19379 7th Ave NE
Poulsbo, WA 98370
Phone (360) 394-1000

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

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

Interoperability endpoints

  • Direct secure messaging: renriquez117875@ghc.direct-ci.net

Organizations & group practices 7

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.

Hospital & facility affiliations 8

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": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352937600000",
    "number": "1780843060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065133",
            "telephone_number": "360-493-4069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065133",
            "telephone_number": "360-493-4069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENRIQUEZ",
        "first_name": "ROMMEL",
        "middle_name": "MONILLAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-03",
        "last_updated": "2012-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "13462",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60284880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MD60284880",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.