Individual provider Active NPI

Deems Okamoto, MD

  • Family Medicine Physician
  • Shoreline, WA
National Provider Identifier
1982697322
Registry record updated Aug 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00014966 Issued in WA
Practice address
14731 Aurora Ave N
Shoreline, WA 98133-6547
Phone
(206) 365-0220
Fax
(206) 365-6436
NPI assigned
Aug 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2010

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 MD00014966 WA Primary

Addresses

Primary practice location

14731 Aurora Ave N
Shoreline, WA 98133-6547

Mailing address

14731 Aurora Ave N
Shoreline, WA 98133-6547
Phone (206) 365-0220

Other identifiers 1

IdentifierTypeStateIssuer
1070804MedicaidWA

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

Practice roles

OrganizationSpecialtyStatusNew patients
Careplus Medical Centers, Inc Family Medicine CurrentSince Dec 1, 2005 Accepting new patients
Ballard Emergency Physicians, P.S. Past Accepting new patients

Locations

14731 Aurora Ave N
Shoreline, WA 98133
Phone (206) 365-0220

Organizations & group practices 2

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": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281916800000",
    "number": "1982697322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14731 AURORA AVE N",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981336547",
            "telephone_number": "206-365-0220",
            "fax_number": "206-365-6436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14731 AURORA AVE N",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981336547",
            "telephone_number": "206-365-0220",
            "fax_number": "206-365-6436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKAMOTO",
        "first_name": "DEEMS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2010-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00014966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1070804",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2010; 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.