Individual provider Active NPI

Andrew M Elizaga, MD

  • Anesthesiology Physician
  • Federal Way, WA
National Provider Identifier
1093719684
Registry record updated Jan 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD00033270 Issued in WA
Practice address
34515 9TH Ave S
Federal Way, WA 98003-6761
Phone
(253) 835-8100
NPI assigned
Jun 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD00033270 WA Primary

Addresses

Primary practice location

34515 9TH Ave S
Federal Way, WA 98003-6761

Mailing address

34515 9TH Ave S
Federal Way, WA 98003-6761
Phone (253) 835-8100

Other identifiers 1

IdentifierTypeStateIssuer
8210536MedicaidWA

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
I20060424000138 WA Practitioner - Anesthesiology 3779592399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Washington School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacific Anesthesia PCGroup PAC ID 2961399290, 91 clinicians

Practice addresses (Care Compare)

1717 S J St
Tacoma, WA 98405-4933
Phone (253) 426-4101

34515 9TH Ave S
Federal Way, WA 98003-6761
Phone (253) 835-8100

Hospital & facility affiliations

  • St Francis Community Hospital Hospital, Federal Way, WA, CCN 500141

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00033270WAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Anesthesia PC Anesthesiology CurrentSince Jul 18, 2018 Accepting new patients
Sound Anesthesia, LLP Anesthesiology Past Accepting new patients
Auburn Anesthesia Associates, Inc. PS Anesthesiology PastSince Jan 1, 2006 Accepting new patients

Locations

11808 Northup Way
Ste W300
Bellevue, WA 98005
Phone (425) 284-1545

16251 Sylvester Rd SW
Burien, WA 98166
Phone (206) 244-9970

34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

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 3

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": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200528000000",
    "number": "1093719684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34515 9TH AVE S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036761",
            "telephone_number": "253-835-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34515 9TH AVE S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036761",
            "telephone_number": "253-835-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELIZAGA",
        "first_name": "ANDREW",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2008-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "MD00033270",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8210536",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

Verify at the official NPI Registry.