NPIMap

Organization Active NPI

Iora Senior Health, LLC

  • Internal Medicine Physician
  • Puyallup, WA
National Provider Identifier
1992299671
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
IORA SENIOR HEALTH, LLC
Practice address
3705 S Meridian Ste B
Puyallup, WA 98373-3709
Phone
(253) 765-5050
Fax
(844) 695-2929
NPI assigned
Jun 18, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Authorized official

Name
Suzanne Hansen
Title
Chief Medicare Program Officer
Phone
(415) 814-0927

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

3705 S Meridian Ste B
Puyallup, WA 98373-3709

Mailing address

1 Embarcadero Ctr FL 19
San Francisco, CA 94111-3628

Other names 1

  • One Medical Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160111002301 WA Part B Supplier - Clinic/Group Practice 0143520189 Receives reassigned benefits from 54 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Tacoma, WA; Shoreline, WA; Seattle, WA; Bellevue, WA; Federal Way, WA; Puyallup, WA; Renton, WA; Kirkland, WA

Other NPIs on the same Medicare enrollment 6

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

National Provider Directory

National Provider Directory
Tax ID family
Iora Senior Health LLC20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1529280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1992299671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR FL 19",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 S MERIDIAN STE B",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733709",
            "telephone_number": "253-765-5050",
            "fax_number": "844-695-2929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IORA SENIOR HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-18",
        "last_updated": "2023-09-07",
        "certification_date": "2023-09-07",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_title_or_position": "CHIEF MEDICARE PROGRAM OFFICER",
        "authorized_official_telephone_number": "415-814-0927"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "One Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.