NPIMap

Individual provider Active NPI

Connie Ruth H Tomada, M.D.

  • Internal Medicine Physician
  • Poulsbo, WA
National Provider Identifier
1982724944
Registry record updated Jan 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD60036801 Issued in WA
Practice address
22180 Olympic College Way NW
Poulsbo, WA 98370-6664
Phone
(360) 779-4444
Fax
(253) 215-1094
NPI assigned
Mar 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD60036801 WA Primary

Addresses

Primary practice location

22180 Olympic College Way NW
Poulsbo, WA 98370-6664

Mailing address

22180 Olympic College Way NW
Poulsbo, WA 98370-6664
Phone (360) 779-4444

Other identifiers 1

IdentifierTypeStateIssuer
2001702MedicaidWA

Other names 1

  • Connie Ruth G Jimenez Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ctomada61704@fhsce.catholichealth.net Direct

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
I20090825000115 WA Practitioner - Internal Medicine 9638223795 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

22180 Olympic College Way NW
Suite 102
Poulsbo, WA 98370-6664
Phone (360) 779-4444

Hospital & facility affiliations

  • Aleca Home Health Home health agency, Silverdale, WA, CCN 507134
  • Signature Healthcare at Home Home health agency, Federal Way, WA, CCN 507110
  • Centerwell Home Health Home health agency, Silverdale, WA, CCN 507106
  • CHI Franciscan Health at Home Home health agency, University Place, WA, CCN 507124
  • St Michael Medical Center Hospital, Silverdale, WA, CCN 500039
  • Jefferson Healthcare Hospital, Port Townsend, WA, CCN 501323
  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Internal Medicine CurrentSince Jul 2, 2017 Accepting new patients
Franciscan Medical Group Current Accepting new patients
Yakima Hma Physician Management LLC Internal Medicine Past Accepting new patients
Franciscan Medical Group Past Accepting new patients
Harrison Medical Center Past Accepting new patients

Locations

2520 Cherry Ave
Bremerton, WA 98310
Phone (360) 377-3911

22180 Olympic College Way NW
Ste 102
Poulsbo, WA 98370
Phone (360) 779-4444

9633 Levin Rd NW
Ste 103
Silverdale, WA 98383
Phone (360) 337-8200

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

Interoperability endpoints

  • Direct secure messaging: ctomada61704@fhsce.catholichealth.net

Organizations & group practices 5

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 11

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": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610928000000",
    "number": "1982724944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22180 OLYMPIC COLLEGE WAY NW",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983706664",
            "telephone_number": "360-779-4444",
            "fax_number": "253-215-1094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22180 OLYMPIC COLLEGE WAY NW",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983706664",
            "telephone_number": "360-779-4444",
            "fax_number": "253-215-1094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOMADA",
        "first_name": "CONNIE RUTH",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60036801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2001702",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ctomada61704@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "22180 Olympic College Way NW",
            "city": "Poulsbo",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983706664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CONNIE RUTH",
            "last_name": "JIMENEZ",
            "middle_name": "G",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Poulsbo, WA

Sources for this page

Verify at the official NPI Registry.