NPIMap

Individual provider Active NPI

Joaquin Aldair Lizaola, PA-C

  • Physician Assistant
  • Tacoma, WA
National Provider Identifier
1821661182
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61366189 Issued in WA
Practice address
1802 Yakima Ave Ste 204
Tacoma, WA 98405-5304
Phone
(253) 627-1244
Fax
(253) 627-6576
NPI assigned
Jul 22, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 61366189 WA
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X PA61366189 WA Primary

Addresses

Primary practice location

1802 Yakima Ave Ste 204
Tacoma, WA 98405-5304

Mailing address

1802 Yakima Ave Ste 204
Tacoma, WA 98405-5304
Phone (253) 627-1244

Other identifiers 1

IdentifierTypeStateIssuer
2229453MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jlizaola709393@fhsce.catholichealth.net Direct Franciscan Medical Group

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
I20230118003140 WA Practitioner - Physician Assistant 9638540263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

11315 Bridgeport Way SW
Lakewood, WA 98499-3004
Phone (253) 426-6341

11511 Canterwood Blvd
Gig Harbor, WA 98332-5813

11511 Canterwood Blvd NW
Suite 100
Gig Harbor, WA 98332-5813
Phone (253) 627-1244

11567 Canterwood Blvd NW
Gig Harbor, WA 98332-5812
Phone (253) 426-6341

1717 S J St
Tacoma, WA 98405-4933
Phone (253) 426-6341

1802 Yakima Ave
Tacoma, WA 98405-5305
Phone (253) 627-1244

1812 S J St
Suite 120
Tacoma, WA 98405-4965
Phone (253) 428-2200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
61366189WAMDPhysician Assistant
PA61366189WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Physician Assistant CurrentSince Jan 9, 2023 Accepting new patients
Franciscan Medical Group CurrentSince Jan 9, 2023 Accepting new patients
Franciscan Medical Group Physician Assistant Past Accepting new patients

Locations

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

1802 Yakima Ave
Ste 304
Tacoma, WA 98405
Phone (253) 572-7101

1802 Yakima Ave
Ste 204
Tacoma, WA 98405
Phone (206) 383-3325

Organizations & group practices 4

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 6

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": "1626912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1821661182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 YAKIMA AVE STE 204",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055304",
            "telephone_number": "253-627-1244",
            "fax_number": "253-627-6576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 YAKIMA AVE STE 204",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055304",
            "telephone_number": "253-627-1244",
            "fax_number": "253-627-6576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIZAOLA",
        "first_name": "JOAQUIN",
        "middle_name": "ALDAIR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-22",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "61366189",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61366189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2229453",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlizaola709393@fhsce.catholichealth.net",
            "affiliation": "Y",
            "affiliationName": "Franciscan Medical Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1802 Yakima Ave Ste 204",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984055304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.