PEDIATRIC HEALTH CARE
NPI 1992965750
Health Maintenance Organization in Puyallup, WA

NPI Status: Active since June 13, 2008

Contact Information

120 14TH AVE SE STE A
PUYALLUP, WA
ZIP 98372
Phone: (253) 848-7660
Fax: (253) 841-1801

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  • Organization
  • Health Maintenance Organization
  • CLIA Number: 50D0998892
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 04-04-2028

About PEDIATRIC HEALTH CARE

This page provides the complete NPI Profile along with additional information for Pediatric Health Care, a provider established in Puyallup, Washington operating as a Health Maintenance Organization. The healthcare provider is registered in the NPI registry with number 1992965750 assigned on June 2008. The practitioner's primary taxonomy code is 302R00000X with license number 025209 MD00038984 (WA). The provider is registered as an organization and their NPI record was last updated 18 years ago. The authorized official of this NPI record is Dr. Mazen Dahan M.d. (Manger)

NPI
1992965750
Provider Name
PEDIATRIC HEALTH CARE
Entity Type
Organization
Location Address
120 14TH AVE SE STE A PUYALLUP, WA 98372
Location Phone
(253) 848-7660
Location Fax
(253) 841-1801
Mailing Address
120 14TH AVE SE STE A PUYALLUP, WA 98372
Mailing Phone
(253) 848-7660
Mailing Fax
(253) 841-1801
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-13-2008
Last Update Date
06-13-2008
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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

Health Maintenance Organization

Taxonomy Code
302R00000X
Type
Managed Care Organizations
License No.
025209 MD00038984
License State
WA
Taxonomy Description
(1) A form of health insurance in which its members prepay a premium for the HMO's health services which generally include inpatient and ambulatory care. For the patient, an HMO means reduced out-of-pocket costs (i.e. no deductible), no paperwork (i.e. insurance forms), and only a small copayment for each office visit to cover the paperwork handled by the HMO; (2) A organization of health care personnel and facilities that provides a comprehensive range of health services to an enrolled population for a fixed sum of money paid in advance for a specified period of time. These health services include a wide variety of medical treatments and consults, inpatient and outpatient hospitalization, home health service, ambulance service, and sometimes dental and pharmacy services. The HMO may be organized as a group model, an individual practice association (IPA), a network model or a staff model.

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.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. MAZEN DAHAN M.D.

Authorized Official Title
MANGER
Authorized Official Phone
(253) 848-7660

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
1115435MEDICAID (05)WA 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
50D0998892
Facility Type
Physician Office
Certificate Effective Date
February 13, 2012
Certificate Expiration Date
April 04, 2028
Laboratory Director
MAZEN DAHAN
Certificate Type
Certificate of Compliance
Certificate Type Description
This CLIA certificate is issued to Pediatric Health Care after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.

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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 1992965750, we treat the final digit (0) 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 70. The final step is to find the difference between that total and the next multiple of ten (70 - 70 = 0).

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.

Pos 1
1
Doubled → 2
Pos 2
9
Unchanged
Pos 3
9
Doubled → 18 → 1 + 8
Pos 4
2
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
6
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
7
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
0
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 9 → 18 → 9 9 → 18 → 9 5 → 10 → 1 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 9 + 1 + 8 + 2 + 1 + 8 + 6 + 1 + 0 + 7 + 1 + 0 + 24 = 70

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 70 is 70. The difference is the calculated check digit.

70 - 70 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1992965750.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1992965750, enumerated as an "organization" on June 13, 2008.

The provider is located at 120 14TH AVE SE STE A PUYALLUP, WA 98372 and the phone number is (253) 848-7660.

Health Maintenance Organization with taxonomy code 302R00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.