NPIMap

Individual provider Active NPI

Cora E Krouse, PA-C

  • Physician Assistant
  • Tacoma, WA
National Provider Identifier
1891768560
Registry record updated Dec 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10003891 Issued in WA
Practice address
1717 S J St
Tacoma, WA 98405-4933
Phone
(253) 426-6341
Fax
(253) 426-6344
NPI assigned
Feb 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA10003891 WA
Physician Assistant 363A00000X PA10003891 WA Primary

Addresses

Primary practice location

1717 S J St
Tacoma, WA 98405-4933

Mailing address

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

Other identifiers 6

IdentifierTypeStateIssuer
8327124MedicaidWA
0238873OtherWASTATE L&I
0273766OtherWASTATE L&I
1021533MedicaidWA
0302690OtherWASTATE L&I
PA10003891OtherWAWA LICENSE

Other names 1

  • Cora E Cummins Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ckrouse12006@fhsce.catholichealth.net Direct

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
I20070226000377 WA Practitioner - Physician Assistant 2365544160 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
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)

1450 Battersby Ave
Enumclaw, WA 98022-3634
Phone (253) 426-6341

1455 Battersby Ave
Enumclaw, WA 98022-3634
Phone (253) 426-6341

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

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

34503 9TH Ave S
Federal Way, WA 98003-8726

Hospital & facility affiliations

  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108
  • St Francis Community Hospital Hospital, Federal Way, WA, CCN 500141

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lewis County Hospital District No. 1 CurrentSince Aug 9, 2024 Accepting new patients
Franciscan Medical Group CurrentSince Dec 8, 2010 Accepting new patients
Franciscan Medical Group CurrentSince Dec 8, 2010 Accepting new patients
Lewis County Hospital District No. 1 CurrentSince Aug 9, 2024 Accepting new patients
Lewis County Hospital District No. 1 Current Accepting new patients
Washington Gastroenterology PLLC Physician Assistant Past Accepting new patients
Franciscan Medical Group Physician Assistant Past Accepting new patients
Franciscan Medical Group Past Accepting new patients
Western Washington Endoscopy Centers LLC Past Accepting new patients
Franciscan Medical Group Past Accepting new patients
Digestive Health Specialists PS Past Accepting new patients

Locations

34515 9th Ave S
#136
Federal Way, WA 98003

34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100

34503 9th Ave S
Ste 130
Federal Way, WA 98003
Phone (253) 835-5340

11567 Canterwood Blvd
Gig Harbor, WA 98332
Phone (253) 530-2000

11307 Bridgeport Way SW
Ste 220A
Lakewood, WA 98499
Phone (253) 985-2733

108 Kindle Rd
Randle, WA 98377
Phone (360) 497-3333

925 Seneca St
Seattle, WA 98101
Phone (206) 341-0860

1708 Yakima Ave
Ste 107
Tacoma, WA 98405
Phone (253) 207-4850

1717 S J St
Stop 136
Tacoma, WA 98405

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

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

11315 Bridgeport Way SW
Tacoma, WA 98499
Phone (253) 588-1711

Interoperability endpoints

  • Direct secure messaging: ckrouse12006@fhsce.catholichealth.net

Organizations & group practices 14

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.

View all 14

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": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1891768560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 S J ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054933",
            "telephone_number": "253-426-6341",
            "fax_number": "253-426-6344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 S J ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054933",
            "telephone_number": "253-426-6341",
            "fax_number": "253-426-6344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROUSE",
        "first_name": "CORA",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-10",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10003891",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10003891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8327124",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "0238873",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "0273766",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1021533",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "0302690",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA LICENSE",
            "identifier": "PA10003891",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ckrouse12006@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1717 S J St",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984054933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CORA",
            "last_name": "CUMMINS",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.