DR. KELLEY A WOODRUFF M.D.
NPI 1619903416
Pediatrics - Adolescent Medicine in Tacoma, WA
NPI Status: Active since June 23, 2006
Contact Information
9040 JACKSAON AVE
TACOMA, WA
ZIP 98431
Phone: (253) 459-5161
- Individual
- Female
- Pediatrics
- Adolescent Medicine
- PECOS Enrolled
About KELLEY WOODRUFF
This page provides the complete NPI Profile along with additional information for Kelley Woodruff, a pediatrician established in Tacoma, Washington with a medical specialization in Pediatrics, focusing in adolescent medicine . The healthcare provider is registered in the NPI registry with number 1619903416 assigned on June 2006. The practitioner's primary taxonomy code is 2080A0000X with license number MD8054 (HI). The provider is registered as an individual and her NPI record was last updated one year ago.
- NPI
- 1619903416
- Provider Name
- DR. KELLEY A WOODRUFF M.D.
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 9040 JACKSAON AVE TACOMA, WA 98431
- Location Phone
- (253) 459-5161
- Mailing Address
- 9040 JACKSAON AVE TACOMA, WA 98431
- Mailing Phone
- (253) 459-5161
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-23-2006
- Last Update Date
- 07-16-2025
- Code Navigator
A pediatrician like Kelley Woodruff is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pediatrics Adolescent Medicine
- Taxonomy Code
- 2080A0000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- MD8054
- License State
- HI
- Taxonomy Description
- A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | MD8054 (HI) |
| 2 | 2080B0002X | Allopathic & Osteopathic Physicians | Pediatrics | MD8054 (HI) |
| 3 | 2080P0207X | Allopathic & Osteopathic Physicians | Pediatrics | MD8054 (HI) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 753021507 | OTHER (01) | HI | HILB,HMA,HMAA |
| 0000D06595 | OTHER (01) | HI | HMSA,HMSA QUEST,BCBS |
| MD805403 | OTHER (01) | HI | AET,NYLC,PBP,UHC,QHCP |
| 05727601 | MEDICAID (05) | HI |
Medicare Participation & PECOS Enrollment Status
Kelley Woodruff is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1619903416, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 64 is 70. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1619903416, enumerated as an "individual" on June 23, 2006.
The provider is located at 9040 JACKSAON AVE TACOMA, WA 98431 and the phone number is (253) 459-5161.
Pediatrics with taxonomy code 2080A0000X and a focus in Adolescent Medicine.
The provider might be accepting Accepts: Medicare, Medicaid and Blue Cross Blue Shield. Please consult your insurance carrier or call the provider to verify.
