Individual provider Active NPI

Michael Keith Bastron, D.C.

  • Chiropractor
  • Federal Way, WA
National Provider Identifier
1023030962
Registry record updated Sep 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0002493 Issued in WA
Practice address
1010 S 336TH Street Suite 120
Federal Way, WA 98003
Phone
(253) 838-5385
Fax
(253) 838-4540
NPI assigned
Jul 23, 2006
Sex
Male
Sole proprietor
Yes

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.

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

31919 1St Ave S
Suite 100
Federal Way, WA 98003-5258
Phone (253) 838-5385

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20080825000311 WA Practitioner - Chiropractic 0345315404 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH0002493WAMDChiropractor

Practice roles (1 of 3)

OrganizationSpecialtyStatusNew patients
Bastron Chiropractic Inc Chiropractor CurrentSince Aug 5, 2008 Accepting new patients

Locations

32123 1st Ave S
Ste A4
Federal Way, WA 98003
Phone (253) 838-5385

31919 1st Ave S
Ste 100
Federal Way, WA 98003
Phone (253) 838-5385

1010 S 336th St
Ste 120
Federal Way, WA 98003
Phone (253) 874-9001

Networks

  • WA PPO C-SNP
  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH0002493 WA Primary

Addresses

NPPES NPI Registry

Primary practice location

1010 S 336TH Street Suite 120
Federal Way, WA 98003

Mailing address

1010 S 336TH Street Suite 120
Federal Way, WA 98003-7354
Phone (253) 838-5385

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 30, 2015.

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443571200000",
    "number": "1023030962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 S 336TH STREET SUITE 120",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980037354",
            "telephone_number": "253-838-5385",
            "fax_number": "253-838-4540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 S 336TH STREET SUITE 120",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "98003",
            "telephone_number": "253-838-5385",
            "fax_number": "253-838-4540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASTRON",
        "first_name": "MICHAEL",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-23",
        "last_updated": "2015-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH0002493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.