NPIMap

Individual provider Active NPI

Simon P Zadina, M.D.

  • Urology Physician
  • Olympia, WA
National Provider Identifier
1124020110
Registry record updated Feb 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD6011602 Issued in WA
Practice address
703 Lilly Rd NE
Suite 106
Olympia, WA 98506-5191
Phone
(360) 350-0281
Fax
(360) 918-8280
NPI assigned
Aug 10, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 33196 MN
Urology Physician 208800000X MD6011602 WA Primary

Addresses

Primary practice location

703 Lilly Rd NE
Suite 106
Olympia, WA 98506-5191

Mailing address

703 Lilly Rd NE
Suite 106
Olympia, WA 98506-5191
Phone (360) 350-0281

Other identifiers 2

IdentifierTypeStateIssuer
0259730OtherWAL&I
208800000XMedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100303000247 WA Practitioner - Urology 4486548500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Nebraska College of Medicine, 1979
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

11307 Bridgeport Way SW
Suite 217
Lakewood, WA 98499-3024
Phone (253) 985-6134

Hospital & facility affiliations

  • St Clare Hospital Hospital, Lakewood, WA, CCN 500021
  • St Joseph Medical Center Hospital, Tacoma, WA, CCN 500108

Merit-based Incentive Payment System (MIPS)

Final score
36 of 100Reported as individual
Quality
15
Improvement activities
0
Cost
100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
33196MNMDUrology Physician
MD6011602WAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince Aug 1, 2025 Accepting new patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group Urology CurrentSince Aug 1, 2025 Accepting new patients
Northland Urology Asso. P.a. PastSince Dec 23, 2003 Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

11307 Bridgeport Way SW
Ste 217
Lakewood, WA 98499
Phone (253) 985-6134

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Interoperability endpoints

  • Direct secure messaging: szadina914093@fhsce.catholichealth.net

Organizations & group practices 5

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 5

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": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424217600000",
    "number": "1124020110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 LILLY RD NE",
            "address_2": "SUITE 106",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065191",
            "telephone_number": "360-350-0281",
            "fax_number": "360-918-8280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 LILLY RD NE",
            "address_2": "SUITE 106",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065191",
            "telephone_number": "360-350-0281",
            "fax_number": "360-918-8280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZADINA",
        "first_name": "SIMON",
        "middle_name": "P",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2015-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MN",
            "license": "33196",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WA",
            "license": "MD6011602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0259730",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208800000X",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.