Individual provider Active NPI

Michael Thomas Cronin

  • Pediatric Critical Care Medicine Physician
  • Seattle, WA
National Provider Identifier
1164797346
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
MD60565171 Issued in WA
Practice address
4800 Sand Point Way NE
A-5950
Seattle, WA 98105-3901
Phone
(206) 987-2525
NPI assigned
Mar 20, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ML 60292260 WA
Pediatric Critical Care Medicine Physician 2080P0203X MD60565171 WA Primary

Addresses

Primary practice location

4800 Sand Point Way NE
A-5950
Seattle, WA 98105-3901

Mailing address

PO Box 50095
Seattle, WA 98145-5095

Other identifiers 1

IdentifierTypeStateIssuer
1164797346MedicaidWA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200922001977 TX Practitioner - Pediatric MedicinePractitioner - Critical Care (Intensivists) 0143538900 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ML 60292260WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dell Children's Medical Group Pediatrics CurrentSince Aug 1, 2020 Accepting new patients
Dell Children's Medical Group Pediatrics Current Accepting new patients
Dell Children's Medical Group CurrentSince Aug 1, 2020 Accepting new patients

Locations

1301 Barbara Jordan Blvd
Ste 200
Austin, TX 78723
Phone (512) 628-1800

4900 Mueller Blvd
Austin, TX 78723
Phone (512) 324-0165

1000 Hesters Crossing Rd
Round Rock, TX 78681
Phone (512) 628-1800

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1332201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1164797346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 SAND POINT WAY NE",
            "address_2": "A-5950",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981053901",
            "telephone_number": "206-987-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRONIN",
        "first_name": "MICHAEL",
        "middle_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-20",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "ML 60292260",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "WA",
            "license": "MD60565171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164797346",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.