Individual provider Active NPI

Ziga Tretjak, MD

  • Gastroenterology Physician
  • Richland, WA
National Provider Identifier
1033186325
Registry record updated Jul 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
60113820 Issued in WA
Practice address
780 Swift Blvd, Suite 270
Kadlec Clinic, Gastroenterology
Richland, WA 99352
Phone
(509) 942-3627
Fax
(509) 943-3280
NPI assigned
Mar 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 60113820 WA Primary

Addresses

Primary practice location

780 Swift Blvd, Suite 270
Kadlec Clinic, Gastroenterology
Richland, WA 99352

Mailing address

9605 Sandifur Pkwy
Pasco, WA 99301-8028
Phone (509) 942-3627

Other identifiers 4

IdentifierTypeStateIssuer
0259824OtherWALABOR & INDUSTRIES
0053CQOtherTXBLUE CROSS BLUE SHIELD
8556128MedicaidWA
113447001MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
60113820WAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Columbia Endoscopy Center, LLC CurrentSince Jan 10, 2020 Accepting new patients
Tri-Cities Digestive Health Center, PS CurrentSince Mar 23, 2013 Accepting new patients
St. Joseph Ambulatory Care Inc Past Accepting new patients

Locations

8819 W Victoria Ave
Ste 130
Kennewick, WA 99336
Phone (509) 460-5500

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.

NPI Registry JSON

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

{
    "created_epoch": "1141516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341446400000",
    "number": "1033186325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9605 SANDIFUR PKWY",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993018028",
            "telephone_number": "509-942-3627",
            "fax_number": "509-547-0827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 SWIFT BLVD, SUITE 270",
            "address_2": "KADLEC CLINIC, GASTROENTEROLOGY",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "99352",
            "telephone_number": "509-942-3627",
            "fax_number": "509-943-3280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRETJAK",
        "first_name": "ZIGA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-05",
        "last_updated": "2012-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WA",
            "license": "60113820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0259824",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0053CQ",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8556128",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113447001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.