Individual provider Active NPI

Wendwesen Kassa Lemma, MD

  • Family Medicine Physician
  • Tacoma, WA
National Provider Identifier
1952183592
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MDCE.ML.61488604 Issued in WA
Practice address
3020 S Union Ave
Tacoma, WA 98409-3317
Phone
(253) 844-4327
NPI assigned
Oct 18, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MDCE.ML.61488604 WA Primary

Addresses

Primary practice location

3020 S Union Ave
Tacoma, WA 98409-3317

Mailing address

808 Fir St Unit 242
Seattle, WA 98104-5144
Phone (425) 626-9905

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
I20250731000835 WA Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 0244677623

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MDCE.ML.61488604WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Heartwood Operator LLC Past Accepting new patients
Alaska Gardens SNF Operations LLC Past Accepting new patients
BD Tacoma I, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: wendwesen.lemma.1@18826.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Heartwood Extended HealthcareTacoma, WA, CCN 505326 Skilled nursing facility Operational/Managerial Control
Adp of the SNF
Apr 1, 2020
Apr 1, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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": "1697587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1952183592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 FIR ST UNIT 242",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981045144",
            "telephone_number": "425-626-9905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 S UNION AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984093317",
            "telephone_number": "253-844-4327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEMMA",
        "first_name": "WENDWESEN",
        "middle_name": "KASSA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-18",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MDCE.ML.61488604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.