Individual provider Active NPI

Stephen R Fischer, PA-C

  • Physician Assistant
  • Chehalis, WA
National Provider Identifier
1083723746
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10000445 Issued in WA
Practice address
2690 NE Kresky Ave
Chehalis, WA 98532-2412
Phone
(360) 330-9595
Fax
(360) 330-9530
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

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 PA10000445 WA Primary

Addresses

Primary practice location

2690 NE Kresky Ave
Chehalis, WA 98532-2412

Mailing address

2690 NE Kresky Ave
Chehalis, WA 98532-2412
Phone (360) 330-9595

Other identifiers 4

IdentifierTypeStateIssuer
8341505MedicaidWA
0131734OtherWALABOR & INDUSTRIES PROV #
F15902OtherWAREGENCE PROVIDER #
1090776MedicaidWA

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
I20070919000558 WA Practitioner - Physician Assistant 7719071935 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
445WAMDClinical Neuropsychologist
PA10000445WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lewis County Community Health Services CurrentSince Feb 16, 2021 Accepting new patients
Lewis County Community Health Services CurrentSince Feb 16, 2021 Accepting new patients
Olympia Orthopaedic Associates PLLC Past Accepting new patients

Locations

2690 NE Kresky Ave
Chehalis, WA 98532
Phone (360) 330-9595

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5512/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1083723746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2690 NE KRESKY AVE",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985322412",
            "telephone_number": "360-330-9595",
            "fax_number": "360-330-9560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2690 NE KRESKY AVE",
            "city": "CHEHALIS",
            "state": "WA",
            "postal_code": "985322412",
            "telephone_number": "360-330-9595",
            "fax_number": "360-330-9530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISCHER",
        "first_name": "STEPHEN",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10000445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8341505",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES PROV #",
            "identifier": "0131734",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE PROVIDER #",
            "identifier": "F15902",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1090776",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chehalis, WA

Sources for this page

Verify at the official NPI Registry.