NPIMap

Individual provider Active NPI

Marvin Paleracio Tolentino, ARNP

  • Family Nurse Practitioner
  • Puyallup, WA
National Provider Identifier
1952646424
Registry record updated Nov 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP60276585 Issued in WA
Practice address
15214 Canyon Rd E
Puyallup, WA 98375-7472
Phone
(253) 539-4200
Fax
(253) 539-6025
NPI assigned
Dec 10, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP60276585 WA Primary

Addresses

Primary practice location

15214 Canyon Rd E
Puyallup, WA 98375-7472

Mailing address

15214 Canyon Rd E
Puyallup, WA 98375-7472
Phone (253) 539-4200

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
I20130214000546 WA Practitioner - Nurse Practitioner 4880848183 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
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)

15214 Canyon Rd E
Suite 100
Puyallup, WA 98375-7472
Phone (253) 539-4200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP60276585WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Current Accepting new patients
Concordia Star Medical LLC CurrentSince Jan 18, 2013 Accepting new patients
Franciscan Medical Group CurrentSince Jul 27, 2015 Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

21 NE Romance Hill Rd
Ste 105
Belfair, WA 98528
Phone (360) 277-2950

9230 Sky Island Dr E
Bonney Lake, WA 98391
Phone (253) 750-6000

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

4700 Point Fosdick Dr
Ste 102
Gig Harbor, WA 98335
Phone (206) 858-3200

15214 Canyon Rd E
Ste 100
Puyallup, WA 98375
Phone (253) 539-4200

118 7th Ave SW
Ste A
Puyallup, WA 98371
Phone (253) 579-0067

15214 Canyon Rd E
Ste 120
Puyallup, WA 98375
Phone (253) 539-4200

4550 Fauntleroy Way SW
Ste 200
Seattle, WA 98126
Phone (206) 933-1041

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

Interoperability endpoints

  • Direct secure messaging: mtolentino126074@fhsce.catholichealth.net

Organizations & group practices 4

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 9

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": "1355097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447632000000",
    "number": "1952646424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15214 CANYON RD E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983757472",
            "telephone_number": "253-539-4200",
            "fax_number": "253-539-6025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15214 CANYON RD E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983757472",
            "telephone_number": "253-539-4200",
            "fax_number": "253-539-6025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLENTINO",
        "first_name": "MARVIN",
        "middle_name": "PALERACIO",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-10",
        "last_updated": "2015-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60276585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.