Individual provider Active NPI

Tristan L Knutson, M.D.

  • Emergency Medicine Physician
  • Tacoma, WA
National Provider Identifier
1912057472
Registry record updated Oct 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
60131079 Issued in WA
Practice address
Madigan Army Medical Ctr
Department of Emergency Medicine
Tacoma, WA 98431-0001
Phone
(253) 968-1250
NPI assigned
Jan 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 60131079 WA Primary
Emergency Medicine Physician 207P00000X 23942 NE

Addresses

Primary practice location

Madigan Army Medical Ctr
Department of Emergency Medicine
Tacoma, WA 98431-0001

Mailing address

Madigan Army Medical Ctr
Department of Emergency Medicine
Tacoma, WA 98431-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100325000462 WA Practitioner - Emergency Medicine 2264568641 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Uniformed Services Uhs Fe Hebert School of Med, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Washington Emergency Physicians PLLCGroup PAC ID 0749514735, 78 clinicians
Mt Rainier Emergency Physicians PLLCGroup PAC ID 7810980968, 25 clinicians

Practice addresses (Care Compare)

14815 Pacific Ave S
Tacoma, WA 98444-4654
Phone (253) 697-8660

401 15TH Ave SE
Puyallup, WA 98372-3715
Phone (253) 697-1848

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23942NEMDEmergency Medicine Physician
60131079WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Emergency Physicians LLC Emergency Medicine CurrentSince Mar 1, 2010 Accepting new patients
Mt. Rainier Emergency Physicians, PLLC Emergency Medicine CurrentSince Aug 7, 2017 Accepting new patients

Locations

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

401 15th Ave SE
Puyallup, WA 98372
Phone (253) 697-1848

Organizations & group practices 3

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 1

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": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414540800000",
    "number": "1912057472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MADIGAN ARMY MEDICAL CTR",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MADIGAN ARMY MEDICAL CTR",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUTSON",
        "first_name": "TRISTAN",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2014-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "60131079",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NE",
            "license": "23942",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.