The Polyclinic PLLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

THE POLYCLINIC PLLC

Doing business as

Optum Tacoma

Practice address

1812 S J St Ste 102
Tacoma, WA 98405-4965

Phone

(253) 552-4900

NPI assigned

Feb 24, 2010

Last updated

Oct 3, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Craig Pepin, MDNPI 1114995511

Title

Physician/Owner

Phone

(206) 860-5414

Specialties & licenses 6

Addresses

Other names 1

• Optum Tacoma Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• The Polyclinic

  • Ambulatory Surgical Clinic/Center
  • Seattle, WA
  • NPI 1073944039

  O20031210000788

  Same enrollment
• The Polyclinic

  • Radiation Oncology Physician
  • Seattle, WA
  • NPI 1962824219

  O20031210000788

  Same enrollment
• The Polyclinic PLLC

  dba Optum - Broadway

  • Audiologist
  • Seattle, WA
  • NPI 1174594634

  O20031210000788

  Same enrollment

Locations

Practitioners 956

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.

• Craig Pepin, M.D.

  • Gastroenterology Physician
  • Seattle, WA
  • NPI 1114995511
  NPD Authorized official
• Eric Michael Abarr, PA-C

  • Physician Assistant
  • Marysville, WA
  • NPI 1598655292
  NPD
• Kim Gittere Abson, MD

  • Dermatology Physician
  • Seattle, WA
  • NPI 1215902135
  NPD
• Kathi Adamson, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Seattle, WA
  • NPI 1184813255
  NPD
• Laura Ngozi Adiele, FNP-BC

  • Family Nurse Practitioner
  • Shoreline, WA
  • NPI 1386077998
  NPD
• Sarmad Aflatooni, MD

  • Hospitalist Physician
  • Everett, WA
  • NPI 1548235518
  NPD
• Kriti Agarwal, MD

  • Internal Medicine Physician
  • Seattle, WA
  • NPI 1629537881
  NPD
• Patricia Agudelo Suarez, MD

  • Obstetrics & Gynecology Physician
  • Seattle, WA
  • NPI 1821139445
  NPD
• Kathrin Leanne Ahl, M.D.

  • Diagnostic Radiology Physician
  • Lynnwood, WA
  • NPI 1790747863
  NPD
• Kinza Taiaba Ahmad, M.D.

  • Retina Specialist (Ophthalmology) Physician
  • Everett, WA
  • NPI 1174056246
  NPD
• Rabiah Naveed Ahmad, PA-C

  • Physician Assistant
  • Seattle, WA
  • NPI 1407519754
  NPD
• Mohamed Anees Ahmed, M.D.

  • Family Medicine Physician
  • Puyallup, WA
  • NPI 1578098257
  NPD

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

{
    "created_epoch": "1266969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727913600000",
    "number": "1831411487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 BROADWAY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981224201",
            "telephone_number": "206-860-5414",
            "fax_number": "206-720-8462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 S J ST STE 102",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054965",
            "telephone_number": "253-552-4900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE POLYCLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-24",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A",
        "authorized_official_last_name": "PEPIN",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "206-860-5414",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optum Tacoma",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• The Progress House Association
• The Upside of Chaos Psychiatry
• Elizabeth Thede
• Kristen Thelen, RN
• Nicholas James Themelis, M.D.

• Durable Medical Equipment & Medical Supplies in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Durable Medical Equipment & Medical Supplies in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; 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.