Individual provider Active NPI

Richard Roy Holman, D.O.

  • Internal Medicine Physician
  • Anacortes, WA
National Provider Identifier
1205240702
Registry record updated Aug 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OP60928607 Issued in WA
Practice address
1211 24TH St
Anacortes, WA 98221
Phone
(360) 299-1300
NPI assigned
Jun 12, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OP60928607 WA Primary

Addresses

Primary practice location

1211 24TH St
Anacortes, WA 98221

Mailing address

1211 24TH St
Anacortes, WA 98221-2562
Phone (360) 299-1300

Other practice location 1

79-01 Broadway, A1-16
Elmhurst Hospital Center
Elmhurst, NY 11373
Phone (718) 334-2488

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
I20190827000550 WA Practitioner - Internal Medicine 1658619606 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Sound Inpatient Physicians PLLCGroup PAC ID 5991618738, 424 clinicians

Practice addresses (Care Compare)

1415 E Kincaid St
Mount Vernon, WA 98274-4126
Phone (360) 424-4111

407 14TH Ave SE
Puyallup, WA 98372-3770
Phone (253) 697-4000

Hospital & facility affiliations

  • Skagit Valley Hospital Hospital, Mount Vernon, WA, CCN 500003

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Hospital Medicine Physicians LLC Internal Medicine CurrentSince Aug 1, 2019 Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine CurrentSince Apr 1, 2025 Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine CurrentSince Apr 1, 2025 Accepting new patients
Public Hospital Dist No 1 Skagit Past Accepting new patients
Public Hospital District No 2 Skagit County Washington Past Accepting new patients

Locations

1211 24th St
Anacortes, WA 98221
Phone (360) 293-3181

3810 Plaza Way
Kennewick, WA 99338
Phone (509) 221-7000

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

Interoperability endpoints

  • Direct secure messaging: rholman63366@skagit.direct-ci.com

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 1

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": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566086400000",
    "number": "1205240702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 24TH ST",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "982212562",
            "telephone_number": "360-299-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 24TH ST",
            "city": "ANACORTES",
            "state": "WA",
            "postal_code": "98221",
            "telephone_number": "360-299-1300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "79-01 Broadway, A1-16",
            "address_2": "Elmhurst Hospital Center",
            "address_purpose": "LOCATION",
            "city": "Elmhurst",
            "state": "NY",
            "postal_code": "11373",
            "country_code": "US",
            "telephone_number": "718-334-2488",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOLMAN",
        "first_name": "RICHARD",
        "middle_name": "ROY",
        "name_prefix": "Mr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-12",
        "last_updated": "2019-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "OP60928607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anacortes, WA

Sources for this page

Verify at the official NPI Registry.