NPIMap

Organization Active NPI

Franciscan Medical Group

Doing business as FMG-Franciscan Surgical Associates

  • Surgery Physician
  • Tacoma, WA
National Provider Identifier
1982639969
Registry record updated Mar 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD00046199 Issued in WA
Legal business name
FRANCISCAN MEDICAL GROUP
Doing business as
FMG-Franciscan Surgical Associates
Practice address
1802 Yakima Ave
Ste 202
Tacoma, WA 98405-4499
Phone
(253) 572-7120
Fax
(253) 572-1071
NPI assigned
Jul 11, 2006
Organization subpart
Yes
Parent organization
FRANCISCAN MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 2, 2009

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

Authorized official

Name
Dean Field, MD
Title
Cmo
Phone
(253) 858-9192

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X MD00046199 WA Primary

Addresses

Primary practice location

1802 Yakima Ave
Ste 202
Tacoma, WA 98405-4499

Mailing address

1802 Yakima Ave
Ste 202
Tacoma, WA 98405-4499
Phone (253) 572-7120

Other identifiers 1

IdentifierTypeStateIssuer
7140064MedicaidWA

Other names 1

  • FMG-Franciscan Surgical Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031111000789 WA Part B Supplier - Clinic/Group Practice 0547173866 Receives reassigned benefits from 1,720 practitioners
This NPI is an additional NPI on the enrollment
O20040209000147 WA Part B Supplier - Clinic/Group Practice 1557254935 Receives reassigned benefits from 27 practitioners
26 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tacoma, WA; University Place, WA; Silverdale, WA; Puyallup, WA; Lakewood, WA; Gig Harbor, WA

Other NPIs on the same Medicare enrollment 26

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 26

National Provider Directory

National Provider Directory
Part of
Enumclaw Medical Center

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235952000000",
    "number": "1982639969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 YAKIMA AVE",
            "address_2": "STE 202",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054499",
            "telephone_number": "253-572-7120",
            "fax_number": "253-572-1071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 YAKIMA AVE",
            "address_2": "STE 202",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054499",
            "telephone_number": "253-572-7120",
            "fax_number": "253-572-1071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRANCISCAN MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRANCISCAN MEDICAL GROUP",
        "enumeration_date": "2006-07-11",
        "last_updated": "2009-03-02",
        "status": "A",
        "authorized_official_last_name": "FIELD",
        "authorized_official_first_name": "DEAN",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "253-858-9192",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD00046199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7140064",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FMG-Franciscan Surgical Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.