Individual provider Active NPI

Somchin Nicholas Puangsuvan, M.D.

  • Anesthesiology Physician
  • Puyallup, WA
National Provider Identifier
1790997427
Registry record updated Jul 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD 60373294 Issued in WA
Practice address
400 E Pioneer
Ste. 101
Puyallup, WA 98372-3255
Phone
(312) 952-9684
NPI assigned
May 4, 2007
Last updated
Jul 5, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD 60373294 WA Primary

Addresses

Primary practice location

400 E Pioneer
Ste. 101
Puyallup, WA 98372-3255

Mailing address

400 E Pioneer
Ste. 101
Puyallup, WA 98372-3255
Phone (312) 952-9684

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131008001187 WA Practitioner - Anesthesiology 7416135728 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Anesthesia Associates PLLCGroup PAC ID 0941112098, 45 clinicians

Practice addresses (Care Compare)

400 S 43Rd St
Renton, WA 98055-5714
Phone (800) 540-1814

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD 60373294WAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rainier Anesthesia Associates PC Anesthesiology CurrentSince Jul 29, 2013 Accepting new patients
Southeast Anesthesia Consultants LTD Anesthesiology Past Accepting new patients

Locations

17700 SE 272nd St
Kent, WA 98042
Phone (253) 372-6500

104 27th Ave SE
Puyallup, WA 98374
Phone (253) 770-4099

400 E Pioneer
Ste 101
Puyallup, WA 98372
Phone (253) 445-5828

Organizations & group practices 3

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 2

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": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467676800000",
    "number": "1790997427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E PIONEER",
            "address_2": "STE. 101",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723255",
            "telephone_number": "312-952-9684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E PIONEER",
            "address_2": "STE. 101",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723255",
            "telephone_number": "312-952-9684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUANGSUVAN",
        "first_name": "SOMCHIN",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2016-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "MD 60373294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.