Individual provider Active NPI

Thomas J. Mueller, MD

  • Specialist
  • Everett, WA
National Provider Identifier
1790869030
Registry record updated Jan 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD00025076 Issued in WA
Practice address
5929 Evergreen Way
Suite 200
Everett, WA 98203-6031
Phone
(425) 258-4361
Fax
(425) 259-5270
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD00025076 WA Primary

Addresses

Primary practice location

5929 Evergreen Way
Suite 200
Everett, WA 98203-6031

Mailing address

5929 Evergreen Way
Suite 200
Everett, WA 98203-6031
Phone (425) 258-4361

Other identifiers 2

IdentifierTypeStateIssuer
1160464MedicaidWA
R32456OtherWAREGENCE

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

LicenseStateTypeSpecialty
MD00025076WAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Everett E N T PS Inc Current Accepting new patients

Locations

12800 Bothell Everett Hwy
Ste 270
Everett, WA 98208
Phone (425) 316-5100

5929 Evergreen Way
Ste 200
Everett, WA 98203
Phone (425) 225-2630

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294358400000",
    "number": "1790869030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5929 EVERGREEN WAY",
            "address_2": "SUITE 200",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982036031",
            "telephone_number": "425-258-4361",
            "fax_number": "425-259-5270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5929 EVERGREEN WAY",
            "address_2": "SUITE 200",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982036031",
            "telephone_number": "425-258-4361",
            "fax_number": "425-259-5270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUELLER",
        "first_name": "THOMAS",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2011-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MD00025076",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1160464",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "R32456",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.