Individual provider Active NPI

Matthew Bartindale, M.D.

  • Otolaryngology Physician
  • Edmonds, WA
National Provider Identifier
1033539721
Registry record updated Jul 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD60934292 Issued in WA
Practice address
21911 76TH Ave W Ste 211
Edmonds, WA 98026
Phone
(425) 775-6651
Fax
(425) 670-6718
NPI assigned
Apr 21, 2014
Last updated
Jul 12, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 125065677 IL
Otolaryngology Physician 207Y00000X MD60934292 WA Primary
Otology & Neurotology Physician 207YX0901X MD60934292 WA

Addresses

Primary practice location

21911 76TH Ave W Ste 211
Edmonds, WA 98026

Mailing address

21911 76TH Ave W Ste 211
Edmonds, WA 98026-7918
Phone (425) 775-6651

Other practice location 1

2160 S 1st Ave
Maywood, IL 60153-3328
Phone (708) 216-1676

Other practice location 2

104 27th Ave SE
Puyallup, WA 98374-1145
Phone (425) 775-6651

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190808000698 WA Practitioner - Otolaryngology 1153623624 Reassigns benefits to 1 organization
I20200831000200 IL Practitioner - Otolaryngology 1153623624 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Loyola University of Chicago, Stritch School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT Surgical Consultants LTDGroup PAC ID 2668446584, 16 clinicians

Practice addresses (Care Compare)

2201 Gleenwood Ave
Joliet, IL 60435-5574
Phone (815) 725-1191

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60934292WAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc P S Current Accepting new patients
Proliance Surgeons Inc P S CurrentSince Aug 1, 2019 Accepting new patients
Proliance Surgeons, Inc., P.S. Otolaryngology CurrentSince Aug 1, 2019 Accepting new patients
ENT Surgical Consultants, LTD Otolaryngology CurrentSince Sep 1, 2020 Accepting new patients

Locations

2201 Glenwood Ave
Joliet, IL 60435
Phone (815) 725-1191

960 W US Route 6
Morris, IL 60450

1890 Silver Cross Blvd
Ste 435
New Lenox, IL 60451
Phone (815) 725-1191

21911 76th Ave W
Ste 211
Edmonds, WA 98026
Phone (253) 770-9000

104 27th Ave SE
Puyallup, WA 98374
Phone (253) 770-4099

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

Interoperability endpoints

  • Direct secure messaging: matthewbartindale@entsc.allscriptsdirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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": "1398038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1033539721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21911 76TH AVE W STE 211",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267918",
            "telephone_number": "425-775-6651",
            "fax_number": "425-670-6718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21911 76TH AVE W STE 211",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "98026",
            "telephone_number": "425-775-6651",
            "fax_number": "425-670-6718"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2160 S 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Maywood",
            "state": "IL",
            "postal_code": "601533328",
            "country_code": "US",
            "telephone_number": "708-216-1676",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "104 27th Ave SE",
            "address_purpose": "LOCATION",
            "city": "Puyallup",
            "state": "WA",
            "postal_code": "983741145",
            "country_code": "US",
            "telephone_number": "425-775-6651",
            "fax_number": "425-670-6718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARTINDALE",
        "first_name": "MATTHEW",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-21",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "125065677",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WA",
            "license": "MD60934292",
            "primary": true
        },
        {
            "code": "207YX0901X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otology & Neurotology",
            "state": "WA",
            "license": "MD60934292",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

Verify at the official NPI Registry.