Individual provider Active NPI

Debora W Overstreet, MD

  • Pediatrics Physician
  • University Place, WA
National Provider Identifier
1841201589
Registry record updated Nov 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD00034281 Issued in WA
Practice address
7210 40TH St W
Ste 100
University Place, WA 98466-4237
Phone
(253) 564-0170
Fax
(253) 207-4240
NPI assigned
Aug 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD00034281 WA Primary

Addresses

Primary practice location

7210 40TH St W
Ste 100
University Place, WA 98466-4237

Mailing address

7210 40TH St W
Ste 100
University Place, WA 98466-4237
Phone (253) 564-0170

Other identifiers 4

IdentifierTypeStateIssuer
126520OtherWAL & I
8930013OtherWACRIME VICTIMS
8198616MedicaidWA
370013716OtherWARAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090817000661 WA Practitioner - Pediatric Medicine 5496809014 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00034281WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group Pediatrics CurrentSince Mar 15, 2013 Accepting new patients
Franciscan Medical Group Past Accepting new patients
Commonspirit Washington Past Accepting new patients
Fox Medical Center PastSince Jun 27, 2021 Accepting new patients

Locations

6401 Kimball Dr
Gig Harbor, WA 98335
Phone (253) 858-4335

11307 Bridgeport Way SW
Ste 200
Lakewood, WA 98499
Phone (253) 985-6688

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

4620 Bridgeport Way W
University Place, WA 98466
Phone (253) 564-0170

7210 40th St W
Ste 100
University Place, WA 98466
Phone (253) 564-0170

Interoperability endpoints

  • Direct secure messaging: doverstreet21754@fhsce.catholichealth.net

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290470400000",
    "number": "1841201589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7210 40TH ST W",
            "address_2": "STE 100",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664237",
            "telephone_number": "253-564-0170",
            "fax_number": "253-207-4240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7210 40TH ST W",
            "address_2": "STE 100",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664237",
            "telephone_number": "253-564-0170",
            "fax_number": "253-207-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OVERSTREET",
        "first_name": "DEBORA",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2010-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00034281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "126520",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS",
            "identifier": "8930013",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8198616",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "370013716",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in University Place, WA

Sources for this page

Verify at the official NPI Registry.