Individual provider Active NPI

Neihl Omar Suwarno, P.A. - C

  • Physician Assistant
  • Seattle, WA
National Provider Identifier
1093771537
Registry record updated Jan 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10004525 Issued in WA
Practice address
1100 9TH Ave
Seattle, WA 98101-2756
Phone
(206) 223-2319
Fax
(360) 756-6666
NPI assigned
Apr 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2013

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 PA10004525 WA Primary

Addresses

Primary practice location

1100 9TH Ave
Seattle, WA 98101-2756

Mailing address

1100 Olive Way
M4-PFS
Seattle, WA 98101-1873
Phone (206) 515-5811

Other identifiers 2

IdentifierTypeStateIssuer
1093771537OtherWAMONTANA DSHS
8372674MedicaidWA

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
I20031107000147 WA Practitioner - Physician Assistant 2769395607 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virginia Mason Medical CenterGroup PAC ID 9830002617, 867 clinicians

Practice addresses (Care Compare)

1100 9TH Ave
Seattle, WA 98101-2756
Phone (206) 223-6600

4575 Sand Point Way NE
Suite 108
Seattle, WA 98105-3999
Phone (206) 525-8000

925 Seneca St
Seattle, WA 98101-2742
Phone (206) 223-6600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA10004525WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Mason Medical Center CurrentSince Sep 14, 2009 Accepting new patients
Virginia Mason Medical Center CurrentSince Sep 14, 2009 Accepting new patients

Locations

1100 9th Ave
Seattle, WA 98101
Phone (206) 223-6980

4575 Sand Point Way NE
Ste 108
Seattle, WA 98105
Phone (206) 525-8000

Interoperability endpoints

  • Direct secure messaging: omar.suwarno@direct.vmmc.org

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 1

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": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357862400000",
    "number": "1093771537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 OLIVE WAY",
            "address_2": "M4-PFS",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011873",
            "telephone_number": "206-515-5811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 9TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012756",
            "telephone_number": "206-223-2319",
            "fax_number": "360-756-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUWARNO",
        "first_name": "NEIHL",
        "middle_name": "OMAR",
        "credential": "P.A. - C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2013-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10004525",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MONTANA DSHS",
            "identifier": "1093771537",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8372674",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.