Individual provider Active NPI

Saydee Homolka, PA-C

  • Physician Assistant
  • Bonney Lake, WA
National Provider Identifier
1093594434
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61456806 Issued in WA
Practice address
10004 204TH Ave E Ste 2200
Bonney Lake, WA 98391-6537
Phone
(253) 447-3300
NPI assigned
Sep 25, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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 PA61456806 WA Primary

Addresses

Primary practice location

10004 204TH Ave E Ste 2200
Bonney Lake, WA 98391-6537

Mailing address

10004 204TH Ave E Ste 2200
Bonney Lake, WA 98391-6537
Phone (253) 447-3300

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
I20240404002883 WA Practitioner - Physician Assistant 7719325158 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

10004 204TH Ave E
Suite 1300
Bonney Lake, WA 98391-6537
Phone (253) 848-8797

311 S L St
Tacoma, WA 98405-3720

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

Hospital & facility affiliations

  • Multicare Good Samaritan Home Health Home health agency, Tacoma, WA, CCN 507046
  • Puget Sound Home Health Home health agency, Tacoma, WA, CCN 507101
  • Wesley Homes at Home, LLC Home health agency, Des Moines, WA, CCN 507092
  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129
  • Multicare Good Samaritan Hospital Hospital, Puyallup, WA, CCN 500079
  • Multicare Covington Medical Center Hospital, Covington, WA, CCN 500154

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA61456806WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Apr 26, 2024 Accepting new patients
Multicare Health System CurrentSince Apr 26, 2024 Accepting new patients
Multicare Health System Physician Assistant Past Accepting new patients

Locations

10004 204th Ave E
Ste 2200
Bonney Lake, WA 98391
Phone (253) 447-3300

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

4215 49th Ave NE
Tacoma, WA 98422
Phone (253) 459-7699

521 S K St
Tacoma, WA 98405
Phone (253) 403-2900

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Organizations & group practices 4

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 6

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": "1695600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1093594434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10004 204TH AVE E STE 2200",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983916537",
            "telephone_number": "253-447-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10004 204TH AVE E STE 2200",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983916537",
            "telephone_number": "253-447-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMOLKA",
        "first_name": "SAYDEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-25",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61456806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonney Lake, WA

Sources for this page

Verify at the official NPI Registry.