NPIMap

Organization Active NPI

South Sound Neurosurgery PLLC

  • Durable Medical Equipment & Medical Supplies
  • Puyallup, WA
National Provider Identifier
1013503523
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SOUTH SOUND NEUROSURGERY PLLC
Practice address
1519 3Rd St SE Ste 101
Puyallup, WA 98372-3742
Phone
(253) 841-8939
Fax
(253) 770-5482
NPI assigned
Dec 18, 2020
Last updated
Apr 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

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

Authorized official

Name
Cathie Rosa
Title
Business Manager
Phone
(253) 604-1413

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

1519 3Rd St SE Ste 101
Puyallup, WA 98372-3742

Mailing address

1519 3Rd St SE Ste 101
Puyallup, WA 98372-3742
Phone (253) 841-8939

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210202001513 WA DME Supplier - Physician - NeurosurgeryDME Supplier - Physician - Orthopedic/Orthopedic Surgery 1254225899 Practice locations: Puyallup, WA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

1310 116th Ave NE
Ste A
Bellevue, WA 98004
Phone (425) 440-3351

1519 3rd St SE
Ste 102
Puyallup, WA 98372
Phone (253) 627-7338

9615 Levin Rd NW
Ste 103
Silverdale, WA 98383
Phone (253) 841-0842

1802 Yakima Ave
Ste 306
Tacoma, WA 98405
Phone (253) 627-7338

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9932/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1608249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744329600000",
    "number": "1013503523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1519 3RD ST SE STE 101",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723742",
            "telephone_number": "253-841-8939",
            "fax_number": "253-770-5482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1519 3RD ST SE STE 101",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723742",
            "telephone_number": "253-841-8939",
            "fax_number": "253-770-5482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SOUND NEUROSURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-18",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A",
        "authorized_official_last_name": "ROSA",
        "authorized_official_first_name": "CATHIE",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "253-604-1413"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 11, 2025; 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.