NPIMap

Individual provider Active NPI

Fabiola Eloisa Puga Duenas, MD

  • Family Medicine Physician
  • Morton, WA
National Provider Identifier
1912567397
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD61230186 Issued in WA
Practice address
521 Adams Ave Ste B
Morton, WA 98356-9323
Phone
(360) 496-5145
NPI assigned
Jun 18, 2019
Last updated
Feb 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X MD61230186 WA Primary

Addresses

Primary practice location

521 Adams Ave Ste B
Morton, WA 98356-9323

Mailing address

PO Box 1138
Morton, WA 98356-0019
Phone (360) 496-5112

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address fabiolapuga@myarborhealth.cernerdirect.com Health Information Exchange (HIE)

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
I20220728002856 WA Practitioner - Family Practice 7214262898 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lewis County Hospital District No 1Group PAC ID 6002727385, shared by 7 NPIs, 27 clinicians

Practice addresses (Care Compare)

521 Adams Ave
Suite B
Morton, WA 98356-9323
Phone (360) 496-5145

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD61230186WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lewis County Hospital District No 1 Current Accepting new patients
Lewis County Hospital District No. 1 CurrentSince Aug 1, 2022 Accepting new patients
Lewis County Hospital District No. 1 Family Medicine CurrentSince Aug 1, 2022 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients
Lewis County Hospital District No 1 Past Accepting new patients
Lewis County Hospital District No. 1 Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: fabiolapuga@myarborhealth.cernerdirect.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1912567397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1138",
            "city": "MORTON",
            "state": "WA",
            "postal_code": "983560019",
            "telephone_number": "360-496-5112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 ADAMS AVE STE B",
            "city": "MORTON",
            "state": "WA",
            "postal_code": "983569323",
            "telephone_number": "360-496-5145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUGA DUENAS",
        "first_name": "FABIOLA",
        "middle_name": "ELOISA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-18",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61230186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fabiolapuga@myarborhealth.cernerdirect.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "521 Adams Ave Ste B",
            "city": "Morton",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983569323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Morton, WA

Sources for this page

Verify at the official NPI Registry.