Individual provider Active NPI

Daniel Max McLean, MPAS, PA-C

  • Physician Assistant
  • Ridgefield, WA
National Provider Identifier
1083955090
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.PA.61311294 Issued in WA
Practice address
8507 S 5TH St Ste 113
Ridgefield, WA 98642-3422
Phone
(360) 887-9494
NPI assigned
Mar 15, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PAD T 2368 AK
Medical Physician Assistant 363AM0700X 1211 AK
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X PA.PA.61311294 WA Primary

Addresses

Primary practice location

8507 S 5TH St Ste 113
Ridgefield, WA 98642-3422

Mailing address

8507 S 5TH St Ste 113
Ridgefield, WA 98642-3422
Phone (360) 887-9494

Other practice location 1

1331 N Goerig St Ste C
Woodland, WA 98674-8414
Phone (360) 887-9494

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
I20221222001937 WA Practitioner - Physician Assistant 5092038885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Oregon Health Sciences University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ridgefield Family Medicine PLLCGroup PAC ID 4981639473, 7 clinicians

Practice addresses (Care Compare)

8507 S 5TH St
Suite 113
Ridgefield, WA 98642-3422
Phone (360) 887-9494

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.42 of 100Reported as group
Quality
94.47
Promoting interoperability
100
Improvement activities
40
Cost
80.26

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1211AKMDGeneral Practice Dentistry
PAD T 2368AKMDPhysician Assistant
PA.PA.61311294WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ridgefield Family Medicine, PLLC CurrentSince Oct 9, 2022 Accepting new patients
Peninsula Community Health Services of Alaska, Inc. Past Accepting new patients

Locations

8507 S 5th St
Ste 113
Ridgefield, WA 98642
Phone (360) 887-9494

1331 N Goerig St
Ste C
Woodland, WA 98674
Phone (360) 887-9494

Interoperability endpoints

  • Direct secure messaging: daniel.max.mclean.1@7156.direct.athenahealth.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/AEIFAA

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.

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": "1363305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1083955090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8507 S 5TH ST STE 113",
            "city": "RIDGEFIELD",
            "state": "WA",
            "postal_code": "986423422",
            "telephone_number": "360-887-9494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8507 S 5TH ST STE 113",
            "city": "RIDGEFIELD",
            "state": "WA",
            "postal_code": "986423422",
            "telephone_number": "360-887-9494"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1331 N Goerig St Ste C",
            "address_purpose": "LOCATION",
            "city": "Woodland",
            "state": "WA",
            "postal_code": "986748414",
            "country_code": "US",
            "telephone_number": "360-887-9494",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCLEAN",
        "first_name": "DANIEL",
        "middle_name": "MAX",
        "credential": "MPAS, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-15",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "PAD T 2368",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AK",
            "license": "1211",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA.PA.61311294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgefield, WA

Sources for this page

Verify at the official NPI Registry.