Roland Fuentes, PAC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA10002237 Issued in WA

Practice address

1100 9TH Ave
Seattle, WA 98101-2756

Phone

(206) 223-6600

NPI assigned

Feb 1, 2007

Last updated

Apr 7, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: roland.fuentes@direct.vmmc.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Virginia Mason Medical Center

  dba Virginia Mason Medical Center-Cardiothoracic Surgery

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Seattle, WA
  • NPI 1043375587
  NPD
• Virginia Mason Medical Center

  dba Virginia Mason Medical Center-General Surgery

  • Surgery Physician
  • Seattle, WA
  • NPI 1154487452
  NPD
• Virginia Mason Medical Center

  dba Virginia Mason Medical Center-Crnas

  • Certified Registered Nurse Anesthetist
  • Seattle, WA
  • NPI 1164586020
  NPD
• Virginia Mason Medical Center

  dba Virginia Mason Medical Center-Podiatry

  • Podiatrist
  • Seattle, WA
  • NPI 1215085097
  NPD
• Virginia Mason Medical Center

  dba Virginia Mason Medical Center-Cardiology

  • Cardiovascular Disease Physician
  • Seattle, WA
  • NPI 1225193766
  NPD
• Virginia Mason Medical Center

  dba Virginia Mason Medical Center-Dermatology

  • Dermatology Physician
  • Seattle, WA
  • NPI 1235293101
  NPD
• Virginia Mason Medical Center

  dba Virginia Mason Medical Center-Orthopedic Surgery

  • Orthopaedic Surgery Physician
  • Seattle, WA
  • NPI 1316094816
  NPD
• Virginia Mason Medical Center

  dba Virginia Mason Medical Center-Pulmonology Infectious Disease

  • Pulmonary Disease Physician
  • Seattle, WA
  • NPI 1346304201
  NPD
• Virginia Mason Medical Center

  dba Virginia Mason Medical Center-Audiology

  • Speech-Language Pathologist
  • Seattle, WA
  • NPI 1407911944
  NPD
• Virginia Mason Medical Center

  dba Virginia Mason Medical Center-Neurosurgery

  • Neurological Surgery Physician
  • Seattle, WA
  • NPI 1487701991
  NPD
• Virginia Mason Medical Center

  dba Virginia Mason Medical Center-Urology & Renal Transplant

  • Urology Physician
  • Seattle, WA
  • NPI 1588712376
  NPD
• Virginia Mason Medical Center

  dba Virginia Mason Medical Center-Neurology

  • Neurology Physician
  • Seattle, WA
  • NPI 1598821894
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207526400000",
    "number": "1134267495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 OLIVE WAY MSC M4-PA",
            "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": "206-223-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUENTES",
        "first_name": "ROLAND",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2008-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA10002237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD #",
            "identifier": "2571FU",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA SPECIALIST PIN",
            "identifier": "US2541825",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0039594",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8380453",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gary Fudem, M.D.
• Fuel Spine & Sports Therapy
• Jennifer D Fuentes, LMHC
• Molly Marie Fuentes, M.D.
• Myrvie Fuentes
• Sandra Fuentes, CAAR.CG.60900085APR
• Walter Vladimir Fuentes, DDS
• Beth Marie-Jean Fugate
• Jessica Evans Fugate, PA
• Kathleen Fugere, ARNP

• Surgical Physician Assistant in Seattle, WA
• Providers in Seattle, WA by specialty
• Surgical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.