Individual provider Active NPI

Marina Cheng, MD

  • Surgery Physician
  • Silverdale, WA
National Provider Identifier
1174720569
Registry record updated Apr 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD60271597 Issued in WA
Practice address
2200 NW Myhre Road
Silverdale, WA 98383-7681
Phone
(360) 830-1100
Fax
(360) 830-1283
NPI assigned
Jun 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 002409 GA
Surgery Physician 208600000X MD60271597 WA Primary

Addresses

Primary practice location

2200 NW Myhre Road
Silverdale, WA 98383-7681

Mailing address

2512 Wheaton Way
Bremerton, WA 98310-3399
Phone (360) 782-3661

Other identifiers 1

IdentifierTypeStateIssuer
002409OtherGARESIDENT TRAINING PERMIT

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120820001192 WA Practitioner - Urology 0547417982 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Georgetown University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services WashingtonGroup PAC ID 6709782600, 480 clinicians

Practice addresses (Care Compare)

149 Lilly Rd NE
Olympia, WA 98506-5028
Phone (360) 486-6772

413 Lilly Rd NE
Olympia, WA 98506-5133
Phone (360) 493-4083

525 Lilly Rd NE
Olympia, WA 98506-5101

Hospital & facility affiliations

  • Providence St Peter Hospital Hospital, Olympia, WA, CCN 500024
  • Providence Centralia Hospital Hospital, Centralia, WA, CCN 500019
  • Arbor Health Morton Hospital Hospital, Morton, WA, CCN 501319

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection19
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002409GAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince Feb 1, 2015 Accepting new patients
Providence Health & Services Washington Current Accepting new patients
Providence Health & Services Washington CurrentSince Feb 1, 2015 Accepting new patients
Providence Health & Services Washington CurrentSince Feb 1, 2015 Accepting new patients

Locations

413 Lilly Rd NE
Olympia, WA 98506
Phone (360) 491-9480

525 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8550

Organizations & group practices 5

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 4

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": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333497600000",
    "number": "1174720569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2512 WHEATON WAY",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983103399",
            "telephone_number": "360-782-3661",
            "fax_number": "360-782-3689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 NW MYHRE ROAD",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983837681",
            "telephone_number": "360-830-1100",
            "fax_number": "360-830-1283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHENG",
        "first_name": "MARINA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-28",
        "last_updated": "2012-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "002409",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD60271597",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RESIDENT TRAINING PERMIT",
            "identifier": "002409",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Silverdale, WA

Sources for this page

Verify at the official NPI Registry.