NPIMap

Organization Active NPI

Harbor Plastic Surgery Center PLLC

  • Ambulatory Surgical Clinic/Center
  • Gig Harbor, WA
National Provider Identifier
1134354533
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
MD00049097 Issued in WA
Legal business name
HARBOR PLASTIC SURGERY CENTER PLLC
Practice address
11511 Canterwood Blvd NW
Suite 310
Gig Harbor, WA 98332-5813
Phone
(253) 858-5040
Fax
(888) 843-2412
NPI assigned
May 28, 2009
Last updated
Dec 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Authorized official

Name
Dr. Justin Howard Piasecki, M.D.NPI 1700848355
Title
Member
Phone
(253) 509-4438

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X MD00049097 WA Primary

Addresses

Primary practice location

11511 Canterwood Blvd NW
Suite 310
Gig Harbor, WA 98332-5813

Mailing address

11511 Canterwood Blvd NW
Suite 310
Gig Harbor, WA 98332-5813
Phone (253) 858-5040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111122000943 WA Part B Supplier - Ambulatory Surgical Center 1153595426 Practice locations: Gig Harbor, WA

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Harbor Plastic Surgery Center PLLCCCN 50C0001291
Medicare certification status
Terminated Voluntary: merger or closure, Dec 18, 2025From the Provider of Services file

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1243468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765929600000",
    "number": "1134354533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 CANTERWOOD BLVD NW",
            "address_2": "SUITE 310",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983325813",
            "telephone_number": "253-858-5040",
            "fax_number": "888-843-2412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11511 CANTERWOOD BLVD NW",
            "address_2": "SUITE 310",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983325813",
            "telephone_number": "253-858-5040",
            "fax_number": "888-843-2412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR PLASTIC SURGERY CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-28",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A",
        "authorized_official_last_name": "PIASECKI",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "HOWARD",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "253-509-4438",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "WA",
            "license": "MD00049097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gig Harbor, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.