Individual provider Active NPI

John D Patz, DO

  • Addiction Medicine (Family Medicine) Physician
  • Monroe, WA
National Provider Identifier
1073549002
Registry record updated Nov 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
License
OP00001308 Issued in WA
Practice address
14841 179TH Ave SE
Suite 210
Monroe, WA 98272-1127
Phone
(360) 217-1155
Fax
(360) 217-1154
NPI assigned
Jun 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) Physician 207QA0401X OP00001308 WA Primary

Addresses

Primary practice location

14841 179TH Ave SE
Suite 210
Monroe, WA 98272-1127

Mailing address

14841 179TH Ave SE
Suite 210
Monroe, WA 98272-1127
Phone (360) 217-1155

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040610001669 WA Practitioner - Family Practice 0143203018 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OP00001308WAMDAddiction Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services-Wa Current Accepting new patients
King County Public Hospital District No. 2 CurrentSince Feb 6, 2013 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
Providence Health & Services-Wa CurrentSince Jan 1, 2009 Accepting new patients
Public Hospital District No 1 of Snohomish County CurrentSince Aug 20, 2013 Accepting new patients
Providence Health & Services-Washington CurrentSince Jan 1, 2009 Accepting new patients
King County Public Hospital District No 2 CurrentSince Feb 6, 2013 Accepting new patients
Public Hospital District 1 of Snohomish County CurrentSince Aug 20, 2013 Accepting new patients
King County Public Hospital District No. 2 Current Accepting new patients
The Polyclinic PLLC Past Accepting new patients

Locations

1909 214th St SE
Ste 110
Bothell, WA 98021
Phone (425) 488-4988

14720 Main St NE
Ste 109
Duvall, WA 98019
Phone (425) 788-4889

916 Pacific Ave
Fl First
Everett, WA 98201
Phone (425) 258-7390

900 Pacific Ave
Fl 5
Everett, WA 98201
Phone (425) 258-7311

12039 NE 128th St
Ste 300
Kirkland, WA 98034
Phone (425) 899-3123

12303 NE 130th Ln
Ste 550
Kirkland, WA 98034
Phone (425) 899-3224

14701 179th Ave SE
Monroe, WA 98272
Phone (360) 794-1409

14841 179th Ave SE
Ste 210
Monroe, WA 98272
Phone (360) 217-1155

4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

Organizations & group practices 11

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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701216000000",
    "number": "1073549002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14841 179TH AVE SE",
            "address_2": "SUITE 210",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982721127",
            "telephone_number": "360-217-1155",
            "fax_number": "360-217-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14841 179TH AVE SE",
            "address_2": "SUITE 210",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982721127",
            "telephone_number": "360-217-1155",
            "fax_number": "360-217-1154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATZ",
        "first_name": "JOHN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2023-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "WA",
            "license": "OP00001308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, WA

Sources for this page

Verify at the official NPI Registry.