Individual provider Active NPI

Gregory James Pendle, PA-C

  • Medical Physician Assistant
  • Olympia, WA
National Provider Identifier
1174780282
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
Practice address
700 Lilly Rd NE
Olympia, WA 98506-5115
Phone
(360) 923-7000
NPI assigned
May 18, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X Primary

Addresses

Primary practice location

700 Lilly Rd NE
Olympia, WA 98506-5115

Mailing address

700 Lilly Rd NE
Olympia, WA 98506-5115
Phone (360) 923-7000

Other practice location 1

413 Lilly Rd NE
Olympia, WA 98506-5133
Phone (360) 486-6147

Other practice location 2

4800 College St SE
Lacey, WA 98503-4389
Phone (360) 486-2900

Electronic endpoints 2

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync Health Information Exchange (HIE)
Direct Messaging Address gpendle459250@wm.providencedirect.org Direct

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
I20140813000493 WA Practitioner - Physician Assistant 4981772001 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services WashingtonGroup PAC ID 7719873496, 14 clinicians
Kaiser Foundation Health Plan of WashingtonGroup PAC ID 9032022579, 1,519 clinicians

Practice addresses (Care Compare)

413 Lilly Rd NE
Olympia, WA 98506-5133
Phone (360) 491-9480

700 Lilly Rd NE
Olympia, WA 98506-5115
Phone (360) 923-7000

9505 S Steele St
Tacoma, WA 98444-1858
Phone (253) 597-6800

Hospital & facility affiliations

  • Providence St Peter Hospital Hospital, Olympia, WA, CCN 500024

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince Apr 4, 2015 Accepting new patients
South Sound Inpatient Physicians PLLC CurrentSince Apr 1, 2021 Accepting new patients
Providence Health & Services Washington CurrentSince Mar 1, 2017 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Apr 4, 2015 Accepting new patients
Providence Health & Services Washington CurrentSince Aug 1, 2014 Accepting new patients
South Sound Inpatient Physicians PLLC CurrentSince Apr 1, 2021 Accepting new patients
Providence Health & Services Washington CurrentSince Aug 1, 2014 Accepting new patients

Locations

202 N Division St
Auburn, WA 98001
Phone (253) 333-2562

16251 Sylvester Rd SW
Burien, WA 98166
Phone (206) 244-9970

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

700 Lilly Rd NE
Olympia, WA 98506
Phone (360) 923-7000

410 Providence Ln NE
Bldg 2
Olympia, WA 98506
Phone (360) 493-4500

4800 College St SE
Olympia, WA 98503
Phone (360) 456-7575

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

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

2000 Hospital Dr
Sedro Woolley, WA 98284
Phone (360) 856-6021

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: gpendle158756@ghc.direct-ci.net

Organizations & group practices 10

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 2

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": "1211068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1174780282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065115",
            "telephone_number": "360-923-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065115",
            "telephone_number": "360-923-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "413 Lilly Rd NE",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985065133",
            "country_code": "US",
            "telephone_number": "360-486-6147",
            "fax_number": "360-486-6447",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4800 College St SE",
            "address_purpose": "LOCATION",
            "city": "Lacey",
            "state": "WA",
            "postal_code": "985034389",
            "country_code": "US",
            "telephone_number": "360-486-2900",
            "fax_number": "360-486-2970",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENDLE",
        "first_name": "GREGORY",
        "middle_name": "JAMES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-18",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "700 Lilly Rd NE",
            "city": "Olympia",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985065115",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gpendle459250@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "4800 College St SE",
            "city": "Lacey",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985034389",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.