Individual provider Active NPI

Raymond William Weinrich, PA-C

  • Medical Physician Assistant
  • Mount Vernon, WA
National Provider Identifier
1104092758
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA61021806 Issued in WA
Practice address
307 S 13TH St Ste 300
Mount Vernon, WA 98274-4100
Phone
(360) 336-9757
Fax
(360) 814-5267
NPI assigned
May 5, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 106 MP
Medical Physician Assistant 363AM0700X PA61021806 WA Primary

Addresses

Primary practice location

307 S 13TH St Ste 300
Mount Vernon, WA 98274-4100

Mailing address

1400 E Kincaid St
Mount Vernon, WA 98274-4127

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rweinrich46152@skagit.direct-ci.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MP, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210427002911 MP Practitioner - Physician Assistant 7517375900 Reassigns benefits to 1 organization
I20230214001461 WA Practitioner - Physician Assistant 7517375900 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Public Hospital Dist No 1 SkagitGroup PAC ID 6800793522, 321 clinicians

Practice addresses (Care Compare)

1400 E Kincaid St
Mount Vernon, WA 98274-4127
Phone (360) 428-2500

2511 M Ave
Suite D
Anacortes, WA 98221-3897
Phone (360) 293-0308

307 S 13TH St
Suite 300
Mount Vernon, WA 98274-4100
Phone (360) 336-9757

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA61021806WAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital Dist No 1 Skagit CurrentSince Feb 23, 2024 Accepting new patients
Commonwealth Healthcare Corporation CurrentSince Mar 22, 2021 Accepting new patients
Commonwealth Healthcare Corporation CurrentSince Mar 22, 2021 Accepting new patients
Public Hospital Dist No 1 Skagit CurrentSince Feb 23, 2024 Accepting new patients
Public Hospital Dist No 1 Skagit Past Accepting new patients

Locations

2511 M Ave
Ste D
Anacortes, WA 98221
Phone (360) 293-0308

1400 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 428-2586

307 S 13th St
Ste 300
Mount Vernon, WA 98274
Phone (360) 336-9757

Interoperability endpoints

  • Direct secure messaging: rweinich575518@direct.peacehealth.org

Organizations & group practices 7

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": "1209945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1104092758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E KINCAID ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 S 13TH ST STE 300",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744100",
            "telephone_number": "360-336-9757",
            "fax_number": "360-814-5267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINRICH",
        "first_name": "RAYMOND",
        "middle_name": "WILLIAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-05",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MP",
            "license": "106",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA61021806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rweinrich46152@skagit.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "Provider Direct Message",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "307 S 13th St Ste 300",
            "city": "Mount Vernon",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982744100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

Verify at the official NPI Registry.