NPIMap

Organization Active NPI

Platinum Peaks Healthcare PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Tacoma, WA
National Provider Identifier
1821982893
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
PLATINUM PEAKS HEALTHCARE PC
Practice address
3020 S Union Ave
Tacoma, WA 98409-3317
Phone
(253) 844-4327
Fax
(888) 871-0613
NPI assigned
Jun 5, 2025
Last updated
Oct 15, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

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

Authorized official

Name
Manoj Wadhwani
Title
Owner
Phone
(203) 901-2493

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X Primary

Addresses

Primary practice location

3020 S Union Ave
Tacoma, WA 98409-3317

Mailing address

917 Pacific Ave Ste 600
Tacoma, WA 98402-4437
Phone (253) 844-4327

Other practice location 1

821 N St Ste 102
Anchorage, AK 99501-3285
Phone (253) 844-4327

Other practice location 2

5 Research Dr
Shelton, CT 06484-6232
Phone (203) 901-2493

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, AK, WA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20250708001647 CT Part B Supplier - Clinic/Group Practice 0648784157 Receives reassigned benefits from 1 practitioner
Practice locations: Shelton, CT
O20250930002669 AK Part B Supplier - Clinic/Group Practice 0648784157 Receives reassigned benefits from 14 practitioners
Practice locations: Anchorage, AK
O20250930003825 WA Part B Supplier - Clinic/Group Practice 0648784157 Receives reassigned benefits from 53 practitioners
Practice locations: Tacoma, WA

National Provider Directory

National Provider Directory

Locations

3020 S Union Ave
Tacoma, WA 98409
Phone (253) 844-4327

Practitioners & affiliated clinicians

Practitioners 63

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 63

NPI Registry JSON

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

{
    "created_epoch": "1749081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760486400000",
    "number": "1821982893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 PACIFIC AVE STE 600",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984024437",
            "telephone_number": "253-844-4327",
            "fax_number": "888-871-0613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 S UNION AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984093317",
            "telephone_number": "253-844-4327",
            "fax_number": "888-871-0613"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "821 N St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Anchorage",
            "state": "AK",
            "postal_code": "995013285",
            "country_code": "US",
            "telephone_number": "253-844-4327",
            "fax_number": "888-871-0613",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5 Research Dr",
            "address_purpose": "LOCATION",
            "city": "Shelton",
            "state": "CT",
            "postal_code": "064846232",
            "country_code": "US",
            "telephone_number": "203-901-2493",
            "fax_number": "866-497-2991",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PLATINUM PEAKS HEALTHCARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-05",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A",
        "authorized_official_last_name": "WADHWANI",
        "authorized_official_first_name": "MANOJ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-901-2493"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; 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.