Individual provider Active NPI

Donald E Ellingsen, M.D.

  • Orthopaedic Surgery Physician
  • Spokane, WA
National Provider Identifier
1194791343
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD00030696 Issued in WA
Practice address
601 W 5TH Ave Ste 400
Spokane, WA 99204-2715
Phone
(509) 344-2663
Fax
(509) 624-9179
NPI assigned
Feb 27, 2006
Last updated
Nov 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD00030696 WA Primary

Addresses

Primary practice location

601 W 5TH Ave Ste 400
Spokane, WA 99204-2715

Mailing address

601 W 5TH Ave Ste 400
Spokane, WA 99204-2715
Phone (509) 344-2663

Other practice location 1

601 W 5th Ave Ste 500
Spokane, WA 99204-2756
Phone (509) 344-8672

Other identifiers 10

IdentifierTypeStateIssuer
K6401OtherIDBLUE CROSS OF ID
3429OtherWAGROUP HEALTH NW
E40491OtherWAASURIS NW HEALTH
003296600MedicaidID
44492OtherWADEPT OF LABOR & INDUSTRIE
000010002352OtherIDREGENCE BLUE SHIELD
1083740MedicaidWA
200015881OtherWARR MEDICARE
379109600OtherOWCP
8922409OtherWACRIME VICTIMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1194791343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 W 5TH AVE STE 400",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042715",
            "telephone_number": "509-344-2663",
            "fax_number": "509-624-9179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W 5TH AVE STE 400",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042715",
            "telephone_number": "509-344-2663",
            "fax_number": "509-624-9179"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 W 5th Ave Ste 500",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992042756",
            "country_code": "US",
            "telephone_number": "509-344-8672",
            "fax_number": "509-747-7838",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLINGSEN",
        "first_name": "DONALD",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WA",
            "license": "MD00030696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF ID",
            "identifier": "K6401",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH NW",
            "identifier": "3429",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASURIS NW HEALTH",
            "identifier": "E40491",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003296600",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR & INDUSTRIE",
            "identifier": "44492",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "000010002352",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1083740",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "200015881",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "379109600",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS",
            "identifier": "8922409",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.