Active NPI
Stephen R Fischer, PA-C
- Physician Assistant
- Chehalis, WA
National Provider Identifier
1083723746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA10000445
- 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
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 | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8341505 | Medicaid | WA | |
| 0131734 | Other | WA | LABOR & INDUSTRIES PROV # |
| F15902 | Other | WA | REGENCE PROVIDER # |
| 1090776 | Medicaid | WA |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 445 | WA | MD | Clinical Neuropsychologist |
| PA10000445 | WA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lewis County Community Health Services | Current | Accepting new patients | |
| Lewis County Community Health Services | Current | 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
- 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.
-
- Federally Qualified Health Center (FQHC)
- Chehalis, WA
- NPI 1134164692
-
- Family Medicine Physician
- Tumwater, WA
- NPI 1881638559
-
- Federally Qualified Health Center (FQHC)
- Olympia, WA
- NPI 1124739974
-
- Federally Qualified Health Center (FQHC)
- Centralia, WA
- NPI 1811669658
-
- Ambulatory Surgical Clinic/Center
- Olympia, WA
- NPI 1083785398
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.