Individual provider Active NPI

Nicholas Eugene Carpenter, PA-C

  • Physician Assistant
  • Seattle, WA
National Provider Identifier
1043667637
Registry record updated Feb 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60804467 Issued in WA
Practice address
4311 11TH Ave NE
Suite 200
Seattle, WA 98105-6366
Phone
(206) 616-4001
Fax
(206) 616-3889
NPI assigned
May 24, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA60804467 WA Primary

Addresses

Primary practice location

4311 11TH Ave NE
Suite 200
Seattle, WA 98105-6366

Mailing address

4311 11TH Ave NE
Suite 200
Seattle, WA 98105-6366
Phone (206) 616-4001

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
I20180102001599 WA Practitioner - Physician Assistant 4789602186 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1901 S Union Ave
Tacoma, WA 98405-1702
Phone (253) 459-6633

315 Martin Luther King Jr Way
Tacoma, WA 98405-4234
Phone (253) 403-1000

5900 State Hwy 303 NE
Bremerton, WA 98311-3741
Phone (253) 459-6633

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Dec 11, 2017 Accepting new patients
Tacoma Emergency Care Physicians, PLLC CurrentSince Aug 20, 2018 Accepting new patients
Multicare Health System CurrentSince Dec 11, 2017 Accepting new patients
Tacoma Emergency Care Physicians, PLLC CurrentSince Aug 20, 2018 Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

17700 SE 272nd St
Kent, WA 98042
Phone (253) 372-6500

315 S K St
Tacoma, WA 98405
Phone (253) 403-1291

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

14815 Pacific Ave S
Tacoma, WA 98444
Phone (253) 697-8660

Interoperability endpoints

  • Direct secure messaging: ncarpenterest74816@direct.multicare.org

Organizations & group practices 6

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 2

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": "1464048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549238400000",
    "number": "1043667637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4311 11TH AVE NE",
            "address_2": "SUITE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981056366",
            "telephone_number": "206-616-4001",
            "fax_number": "206-616-3889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4311 11TH AVE NE",
            "address_2": "SUITE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981056366",
            "telephone_number": "206-616-4001",
            "fax_number": "206-616-3889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "NICHOLAS",
        "middle_name": "EUGENE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-24",
        "last_updated": "2019-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60804467",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.