Organization Active NPI

Franciscan Medical Group

Doing business as Pacific NW Maternal Fetal Medicine Federal Way

  • Maternal & Fetal Medicine Physician
  • Federal Way, WA
National Provider Identifier
1821105271
Registry record updated Nov 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
License
MD00023541 Issued in WA
Legal business name
FRANCISCAN MEDICAL GROUP
Doing business as
Pacific NW Maternal Fetal Medicine Federal Way
Practice address
34503 9TH Ave S
Ste 200
Federal Way, WA 98003-8727
Phone
(253) 835-6260
Fax
(253) 835-6299
NPI assigned
Aug 23, 2006
Organization subpart
Yes
Parent organization
FRANCISCAN MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 17, 2009

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

Authorized official

Name
Cliff Robertson, MD
Title
Cmo, President
Phone
(253) 779-6101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VM0101X MD00023541 WA Primary

Addresses

Primary practice location

34503 9TH Ave S
Ste 200
Federal Way, WA 98003-8727

Mailing address

34503 9TH Ave S
Ste 200
Federal Way, WA 98003-8727
Phone (253) 835-6260

Other identifiers 2

IdentifierTypeStateIssuer
0214670OtherWASTATE L&I
7134364MedicaidWA

Other names 1

  • Pacific NW Maternal Fetal Medicine Federal Way Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031111000789 WA Part B Supplier - Clinic/Group Practice 0547173866 Receives reassigned benefits from 1,720 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Part of
Enumclaw Medical Center

Locations

34503 9th Ave S
Ste 200
Federal Way, WA 98003
Phone (253) 835-6260

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258416000000",
    "number": "1821105271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34503 9TH AVE S",
            "address_2": "STE 200",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980038727",
            "telephone_number": "253-835-6260",
            "fax_number": "253-835-6299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34503 9TH AVE S",
            "address_2": "STE 200",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980038727",
            "telephone_number": "253-835-6260",
            "fax_number": "253-835-6299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANCISCAN MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRANCISCAN MEDICAL GROUP",
        "enumeration_date": "2006-08-23",
        "last_updated": "2009-11-17",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "CLIFF",
        "authorized_official_title_or_position": "CMO, PRESIDENT",
        "authorized_official_telephone_number": "253-779-6101",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": "WA",
            "license": "MD00023541",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "0214670",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7134364",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific NW Maternal Fetal Medicine Federal Way",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.