NPIMap

Individual provider Active NPI

Edward G Prevatt, M.D.

  • Surgery Physician
  • Mount Vernon, WA
National Provider Identifier
1184019325
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD61223363 Issued in WA
Practice address
1400 E Kincaid St
Mount Vernon, WA 98274-4127
Phone
(360) 428-2586
Fax
(360) 428-6470
NPI assigned
Apr 4, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X MD61223363 WA
Surgery Physician 208600000X MD61223363 WA Primary

Addresses

Primary practice location

1400 E Kincaid St
Mount Vernon, WA 98274-4127

Mailing address

648 Newton PL NW
Apt 2
Washington, DC 20010-1737
Phone (240) 533-1805

Other practice location 1

780 Swift Blvd Ste 101
Richland, WA 99352-3545
Phone (509) 942-3060

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address eprevatt41142@skagit.direct-ci.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221110002449 WA Practitioner - General SurgeryPractitioner - Critical Care (Intensivists) 9133596703 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Critical Care (Intensivists)
Education
Howard University College of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

17700 SE 272ND St
Covington, WA 98042-4951
Phone (253) 372-7030

202 N Division St
Auburn, WA 98001-4939

222 State Ave N
Kent, WA 98030-4544
Phone (253) 372-7788

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Nov 18, 2024 Accepting new patients
Multicare Health System CurrentSince Nov 18, 2024 Accepting new patients
Public Hospital Dist No 1 Skagit CurrentSince Oct 7, 2022 Accepting new patients
Public Hospital Dist No 1 Skagit Current Accepting new patients
Public Hospital Dist No 1 Skagit CurrentSince Oct 7, 2022 Accepting new patients
Kadlec Regional Medical Center CurrentSince Dec 12, 2024 Accepting new patients
Kadlec Regional Medical Center Current Accepting new patients
Kadlec Regional Medical Center CurrentSince Dec 12, 2024 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

1400 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 428-2586

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

1135 Jadwin Ave
Richland, WA 99352
Phone (509) 942-3300

780 Swift Blvd
Ste 101
Richland, WA 99352
Phone (509) 942-3060

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": "1428105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1184019325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "648 NEWTON PL NW",
            "address_2": "APT 2",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200101737",
            "telephone_number": "240-533-1805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E KINCAID ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744127",
            "telephone_number": "360-428-2586",
            "fax_number": "360-428-6470"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "780 Swift Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Richland",
            "state": "WA",
            "postal_code": "993523545",
            "country_code": "US",
            "telephone_number": "509-942-3060",
            "fax_number": "509-942-2297",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PREVATT",
        "first_name": "EDWARD",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-04",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "WA",
            "license": "MD61223363",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD61223363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eprevatt41142@skagit.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "Provider Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1400 E Kincaid St",
            "city": "Mount Vernon",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982744127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

Verify at the official NPI Registry.