Michael Corsilles, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA60191026 Issued in WA

Practice address

8639 36TH Ave SW
Seattle, WA 98126-3609

Phone

(206) 380-5202

NPI assigned

Feb 15, 2007

Last updated

Sep 6, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Previously, effective Oct 1, 2022 through Oct 1, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Functional Health Consulting, LLC

  dba Vida Integrated Health

  • Rehabilitation Chiropractor
  • Everett, WA
  • NPI 1619226891

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536192000000",
    "number": "1023151081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 116TH AVE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043016",
            "telephone_number": "425-467-1314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8639 36TH AVE SW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981263609",
            "telephone_number": "206-380-5202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORSILLES",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2018-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60191026",
            "primary": true
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "WA",
            "license": "NT00001187",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Corinne L Corrigan
• Nicholas Corrin, L.AC.
• Corrina Skildum, PLLC
• James Michael Corroon Jr., N.D.
• Cecille C. Corsilles-Sy, OT
• Andrew Scott Corso, PH.D.
• James Michael Corson
• Marshall A Corson
• Colin Marcus Cortado, PAC
• Vanessa Cortes de Jorge, MD

• Physician Assistant in Seattle, WA
• Providers in Seattle, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.