Individual provider Active NPI

Wayne Mark Duran, M.D.

  • Preferred Provider Organization
  • Auburn, WA
National Provider Identifier
1912099383
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
License
MD 00020201 Issued in WA
Practice address
1402 Lake Tapps Pkwy E
Suite F106
Auburn, WA 98092-8157
Phone
(253) 288-8882
Fax
(253) 288-2283
NPI assigned
Sep 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X MD 00020201 WA Primary

Addresses

Primary practice location

1402 Lake Tapps Pkwy E
Suite F106
Auburn, WA 98092-8157

Mailing address

PO Box 1237
Milton, WA 98354-1237
Phone (253) 288-8882

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD 00020201WAMDPreferred Provider Organization

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Hospital Past Accepting new patients
Access Healthcare, PLLC Past Accepting new patients
Mt. Rainier Emergency Physicians, PLLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: wayne.duran.1@25100.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/25100/brand/2/csg/1/fhir/r4

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.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912099383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1237",
            "city": "MILTON",
            "state": "WA",
            "postal_code": "983541237",
            "telephone_number": "253-288-8882",
            "fax_number": "253-288-2283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 LAKE TAPPS PKWY E",
            "address_2": "SUITE F106",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980928157",
            "telephone_number": "253-288-8882",
            "fax_number": "253-288-2283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DURAN",
        "first_name": "WAYNE",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "WA",
            "license": "MD 00020201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.