Active NPI
Franciscan Medical Group
Doing business as Auburn/Federal Way Surgeons - Auburn
- Surgery Physician
- Auburn, WA
National Provider Identifier
1164437851
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- MD00029862
- Legal business name
- FRANCISCAN MEDICAL GROUP
- Doing business as
- Auburn/Federal Way Surgeons - Auburn
- Practice address
- 200 Auburn Ave
Auburn, WA 98002-5015 - Phone
- (253) 833-1986
- Fax
- (253) 939-0521
- NPI assigned
- Jul 30, 2006
- Organization subpart
- Yes
- Parent organization
- FRANCISCAN MEDICAL GROUP
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Cliff Robertson
- Title
- Chief Medical Officer
- Phone
- (253) 779-6101
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | MD00029862 | WA | Primary |
| Foot & Ankle Surgery Podiatrist | 213ES0103X | PO00000816 | WA |
Addresses
Primary practice location
200 Auburn Ave
Auburn, WA 98002-5015
Mailing address
200 Auburn Ave
Auburn, WA 98002-5015
Phone (253) 833-1986
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7129455 | Medicaid | WA | |
| 7138316 | Medicaid | WA | |
| 0201143 | Other | WA | STATE L&I |
Other names 1
- Auburn/Federal Way Surgeons - Auburn
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031111000789 | WA | Part B Supplier - Clinic/Group Practice | 0547173866 |
Receives reassigned benefits from 1,720 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider Directory- Part of
- Enumclaw Medical Center
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154217600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1234310400000",
"number": "1164437851",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 AUBURN AVE",
"city": "AUBURN",
"state": "WA",
"postal_code": "980025015",
"telephone_number": "253-833-1986",
"fax_number": "253-939-0521"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 AUBURN AVE",
"city": "AUBURN",
"state": "WA",
"postal_code": "980025015",
"telephone_number": "253-833-1986",
"fax_number": "253-939-0521"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FRANCISCAN MEDICAL GROUP",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "FRANCISCAN MEDICAL GROUP",
"enumeration_date": "2006-07-30",
"last_updated": "2009-02-11",
"status": "A",
"authorized_official_last_name": "ROBERTSON",
"authorized_official_first_name": "CLIFF",
"authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
"authorized_official_telephone_number": "253-779-6101"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Surgery",
"state": "WA",
"license": "MD00029862",
"primary": true
},
{
"code": "213ES0103X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "WA",
"license": "PO00000816",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7129455",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7138316",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE L&I",
"identifier": "0201143",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Auburn/Federal Way Surgeons - Auburn",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Auburn, WA
- Sarah Fox, M.A., LMHCA
- Erin Ann Frain
- Courtney L. Francis, MSW, LISCW
- Franciscan Health System (Rakesh Safaya, MD - Auburn)
- Franciscan Medical Group
- Franciscan Medical Group (Franciscan Endocrinology Clinic)
- Franciscan Medical Group (Franciscan Breast Imaging -Auburn)
- Franciscan Medical Group (Franciscan Vascular Associates - Auburn)
- Franciscan Medical Group (Franciscan Heart and Vascular Asssociates-Auburn)
- Dena Ellen Frandsen, MA, LMHC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.