Active NPI
Gavin Dawson
- Physician Assistant
- Seattle, WA
National Provider Identifier
1073163986
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- Medex Northwest 4311 11TH Avenue NE
Seattle, WA 98105 - Phone
- (206) 616-4001
- Fax
- (206) 616-3889
- NPI assigned
- Sep 13, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
Medex Northwest 4311 11TH Avenue NE
Seattle, WA 98105
Mailing address
Medex Northwest 4311 11TH Avenue NE
Seattle, WA 98105
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lipov Medical Group of Ca PC | Current | Accepting new patients |
Locations
12381 Wilshire Blvd
Ste 205
Los Angeles, CA 90025
Phone (213) 894-9696
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568332800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611619200000",
"number": "1073163986",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "MEDEX NORTHWEST 4311 11TH AVENUE NE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "98105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MEDEX NORTHWEST 4311 11TH AVENUE NE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "98105",
"telephone_number": "206-616-4001",
"fax_number": "206-616-3889"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAWSON",
"first_name": "GAVIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-09-13",
"last_updated": "2021-01-26",
"certification_date": "2021-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.