Individual provider Active NPI

Teresa E Vasicek, PA-C

  • Physician Assistant
  • Seattle, WA
National Provider Identifier
1164823282
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60535275 Issued in WA
Practice address
1101 Madison St
Ste 1400
Seattle, WA 98104-4308
Phone
(206) 386-6266
Fax
(206) 386-2844
NPI assigned
Sep 8, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA60535275 WA Primary
Medical Physician Assistant 363AM0700X PA60535275 WA

Addresses

Primary practice location

1101 Madison St
Ste 1400
Seattle, WA 98104-4308

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476

Other identifiers 1

IdentifierTypeStateIssuer
2042600MedicaidWA

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150331002735 WA Practitioner - Physician Assistant 4688991631 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virginia Mason Medical CenterGroup PAC ID 9830002617, 867 clinicians
Swedish Health ServicesGroup PAC ID 0244138196, 1,038 clinicians

Practice addresses (Care Compare)

1100 9TH Ave
Seattle, WA 98101-2756
Phone (206) 223-6600

1101 Madison St
Suite 1400
Seattle, WA 98104-4308
Phone (206) 386-6266

747 Broadway
Seattle, WA 98122-4379
Phone (206) 386-6000

925 Seneca St
Seattle, WA 98101-2742
Phone (206) 223-6600

Hospital & facility affiliations

  • Swedish Medical Center Hospital, Seattle, WA, CCN 500027
  • Virginia Mason Medical Center Hospital, Seattle, WA, CCN 500005
  • Swedish Issaquah Hospital, Issaquah, WA, CCN 500152

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA60535275WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Health Services Past Accepting new patients

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1410134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1164823282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MADISON ST",
            "address_2": "STE 1400",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981044308",
            "telephone_number": "206-386-6266",
            "fax_number": "206-386-2844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASICEK",
        "first_name": "TERESA",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-08",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60535275",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA60535275",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2042600",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.