Individual provider Active NPI

Austin G Hogland, PA-C

  • Physician Assistant
  • Renton, WA
National Provider Identifier
1003213166
Registry record updated Jun 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
60518925 Issued in WA
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

Updated by the provider on Jun 7, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
PENDINGMedicaidWA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171206000206 AZ Practitioner - Physician Assistant 5597080655 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6760AZMDDental Hygienist
60518925WAMDPhysician Assistant
PA60518925WAMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.