Active NPI
Austin G Hogland, PA-C
- Physician Assistant
- Renton, WA
National Provider Identifier
1003213166
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 60518925
- Practice address
- 660 SW 39TH St
Suite 150
Renton, WA 98057-4912 - Phone
- (425) 793-4700
- Fax
- (425) 251-4302
- NPI assigned
- Dec 4, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 60518925 | WA | Primary |
| Medical Physician Assistant | 363AM0700X | PA60518925 | WA |
Addresses
Primary practice location
660 SW 39TH St
Suite 150
Renton, WA 98057-4912
Mailing address
PO Box 59028
Renton, WA 98058-2028
Phone (425) 251-5110
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6760 | AZ | MD | Dental Hygienist |
| 60518925 | WA | MD | Physician Assistant |
| PA60518925 | WA | MD | Medical Physician Assistant |
Interoperability endpoints
- ahogland60223@direct.valleymed.org
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.
-
- Emergency Medicine Physician
- Glendale, AZ
- NPI 1285655209
-
- Emergency Care Clinic/Center
- Gilbert, AZ
- NPI 1245772870
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1417651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465257600000",
"number": "1003213166",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 59028",
"city": "RENTON",
"state": "WA",
"postal_code": "980582028",
"telephone_number": "425-251-5110",
"fax_number": "425-793-4707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "660 SW 39TH ST",
"address_2": "SUITE 150",
"city": "RENTON",
"state": "WA",
"postal_code": "980574912",
"telephone_number": "425-793-4700",
"fax_number": "425-251-4302"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOGLAND",
"first_name": "AUSTIN",
"middle_name": "G",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-12-04",
"last_updated": "2016-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WA",
"license": "60518925",
"primary": true
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WA",
"license": "PA60518925",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PENDING",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Renton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.