Gregory D Fisk, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA60149531 Issued in WA

Practice address

529 Jasmine St
Omak, WA 98841-9589

Phone

(509) 826-1600

Fax

(509) 826-3633

NPI assigned

Dec 27, 2005

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 2

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

Specialty

Physician Assistant

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Okanogan Douglas County Hospital Dist 1Group PAC ID 7810882792, shared by 4 NPIs, 34 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Three Rivers Hospital Hospital, Brewster, WA, CCN 501324
• Mid Valley Hospital & Clinic Hospital, Omak, WA, CCN 501328

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: fiskg@mvhealth.cernerdirect.com

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.

• Okanogan County Public Hospital District No. 3

  • Critical Access Hospital
  • Omak, WA
  • NPI 1255387403
  Medicare reassignment NPD
• Okanogan Douglas County Hospital Dist 1

  • Critical Access Hospital
  • Brewster, WA
  • NPI 1205942257
  Medicare reassignment NPD
• Okanogan Douglas County Hospital Dist 1

  • Critical Access Hospital
  • Brewster, WA
  • NPI 1356305395
  Medicare reassignment NPD
• Okanogan Douglas County Hospital Dist1

  • Critical Access Hospital
  • Brewster, WA
  • NPI 1578649794
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Okanogan County Public Hospital District No. 3

  • Critical Access Hospital
  • Omak, WA
  • NPI 1255387403
  Care Compare affiliation
• Okanogan Douglas County Hospital Dist 1

  • Critical Access Hospital
  • Brewster, WA
  • NPI 1356305395
  Care Compare affiliation
• Okanogan Douglas District Hospital #1

  • Critical Access Hospital
  • Brewster, WA
  • NPI 1043363591
  Care Compare affiliation

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461110400000",
    "number": "1164409637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 JASMINE ST",
            "city": "OMAK",
            "state": "WA",
            "postal_code": "988419589",
            "telephone_number": "509-826-1600",
            "fax_number": "509-826-3633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 JASMINE ST",
            "city": "OMAK",
            "state": "WA",
            "postal_code": "988419589",
            "telephone_number": "509-826-1600",
            "fax_number": "509-826-3633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISK",
        "first_name": "GREGORY",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-27",
        "last_updated": "2016-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60149531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & Z",
            "identifier": "202201",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8439796",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Family Health Centers
• Family Health Centers
• Family Health Centers Dental
• Jodie Dawn Field, M.S.
• Larry Bret Fields, RRT-NPS, RPFT, AE-C
• Jordan Christine Forbush, FNP-BC
• Diane N Foreman
• Kai Forgach
• Nikita Jean Foster, SLP
• Shayne Dianne Freeman, BA

• Physician Assistant in Omak, WA
• Providers in Omak, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.