Individual provider Active NPI

Daniel R. Elliott, PA-C

  • Physician Assistant
  • Richland, WA
National Provider Identifier
1023004033
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10004049 Issued in WA
Practice address
1100 Goethals Dr Ste B
Richland, WA 99352-3301
Phone
(509) 942-3080
Fax
(509) 942-3085
NPI assigned
Sep 26, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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 PA16841 CA
Physician Assistant 363A00000X PA10004049 WA Primary

Addresses

Primary practice location

1100 Goethals Dr Ste B
Richland, WA 99352-3301

Mailing address

550 Gage Blvd Ste 101
Richland, WA 99352-9532
Phone (509) 473-0637

Other practice location 1

29738 Rancho California Rd
Suite B
Temecula, CA 92591-5322
Phone (951) 303-6440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20240513001614 WA Practitioner - Physician Assistant 4082600572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kadlec Regional Medical CenterGroup PAC ID 9739098617, 402 clinicians

Practice addresses (Care Compare)

1100 Goethals Dr
Richland, WA 99352-3301

1135 Jadwin Ave
Richland, WA 99352-3434
Phone (509) 942-3300

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
265WYMDRegistered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kadlec Regional Medical Center CurrentSince May 25, 2024 Accepting new patients
Inland Urgent Care a Medical Corporation CurrentSince Jun 30, 2013 Accepting new patients
Kadlec Regional Medical Center CurrentSince May 25, 2024 Accepting new patients

Locations

31588 Railroad Canyon Rd
Canyon Lake, CA 92587

29738 Rancho California Rd
Ste B
Temecula, CA 92591
Phone (951) 303-6440

36320 Inland Valley Dr
Ste 307
Wildomar, CA 92595
Phone (909) 600-0110

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

1135 Jadwin Ave
Richland, WA 99352
Phone (509) 942-3300

550 Gage Blvd
Ste 101
Richland, WA 99352

1100 Goethals Dr
Ste B
Richland, WA 99352
Phone (509) 942-3062

Organizations & group practices 3

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1023004033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 GAGE BLVD STE 101",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993529532",
            "telephone_number": "509-473-0637",
            "fax_number": "509-627-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 GOETHALS DR STE B",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993523301",
            "telephone_number": "509-942-3080",
            "fax_number": "509-942-3085"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29738 Rancho California Rd",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Temecula",
            "state": "CA",
            "postal_code": "925915322",
            "country_code": "US",
            "telephone_number": "951-303-6440",
            "fax_number": "951-303-6449",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "DANIEL",
        "middle_name": "R.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-26",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA16841",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10004049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

Verify at the official NPI Registry.