Mt Baker Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

MD00040970 Issued in WA

Legal business name

MT BAKER SURGERY CENTER, LLC

Practice address

4029 Northwest Ave
Suite 301
Bellingham, WA 98226-9077

Phone

(360) 752-0518

NPI assigned

May 18, 2012

Last updated

May 18, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Matthew R Peterson, MDNPI 1891785606

Title

Owner

Phone

(360) 752-0518

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matthew R Peterson, MD

  • Pain Medicine (Anesthesiology) Physician
  • Bellingham, WA
  • NPI 1891785606
  Authorized official Same address or phone

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

{
    "created_epoch": "1337299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337299200000",
    "number": "1205196649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8524 W GAGE BLVD STE A1",
            "address_2": "BOX 319",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993368241",
            "telephone_number": "509-591-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4029 NORTHWEST AVE",
            "address_2": "SUITE 301",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982269077",
            "telephone_number": "360-752-0518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT BAKER SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-18",
        "last_updated": "2012-05-18",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-752-0518",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "WA",
            "license": "MD00040970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7144637",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ms Erlich MD, LLC
• Phumeza Msikinya, MD
• Mstreet Services PLLC
• Mt Baker Pain Clinic, P.S.
• Mt Baker Pain Clinic, P.S.
• Mt. Baker Imaging LLC
• Mt. Baker Nephrology Associates Inc PS
• Mt. Baker Vision Clinc
• Patrick Muchmore
• Natasha Muckova, M.D.

• Ambulatory Surgical Clinic/Center in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Ambulatory Surgical Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2012; 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.