Individual provider Active NPI

Peter Bolek Brant-Zawadzki, MD

  • Vascular Surgery Physician
  • Everett, WA
National Provider Identifier
1215134697
Registry record updated Feb 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
MD60222893 Issued in WA
Practice address
1330 Rockefeller
Ste 520
Everett, WA 98201-1677
Phone
(425) 297-5200
Fax
(425) 297-5210
NPI assigned
Jun 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 54144231205 UT
Vascular Surgery Physician 2086S0129X MD60222893 WA Primary

Addresses

Primary practice location

1330 Rockefeller
Ste 520
Everett, WA 98201-1677

Mailing address

PO Box 3360
Providence Health & Services
Portland, OR 97208-3360
Phone (866) 366-2983

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
I20111123000635 WA Practitioner - Vascular SurgeryPractitioner - General Surgery 0941474167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health and Services- WashingtonGroup PAC ID 8325100480, 527 clinicians

Practice addresses (Care Compare)

1321 Colby Ave
Everett, WA 98201-1665
Phone (425) 261-2000

1330 Rockefeller Ave
Everett, WA 98201-1677

4112 Harbour Pointe Blvd SW
Suite 100
Mukilteo, WA 98275-5457
Phone (425) 347-6330

Hospital & facility affiliations

  • Providence Regional Medical Center Everett Hospital, Everett, WA, CCN 500014
  • Skagit Valley Hospital Hospital, Mount Vernon, WA, CCN 500003
  • Cascade Valley Hospital Hospital, Arlington, WA, CCN 500060

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Leg revascularization (restoring blood flow)21

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54144231205UTMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Vascular Incorporated CurrentSince Dec 14, 2021 Accepting new patients
Pacific Vascular Incorporated CurrentSince Dec 14, 2021 Accepting new patients
Pacific Vascular Incorporated CurrentSince Dec 14, 2021 Accepting new patients
Pacific Vascular Incorporated CurrentSince Dec 14, 2021 Accepting new patients
Pacific Vascular Incorporated CurrentSince Dec 14, 2021 Accepting new patients
Pacific Vascular Incorporated CurrentSince Dec 14, 2021 Accepting new patients
Pacific Vascular Incorporated CurrentSince Dec 14, 2021 Accepting new patients
Providence Health & Services - Washington CurrentSince Sep 4, 2011 Accepting new patients
Pacific Vascular Incorporated CurrentSince Dec 14, 2021 Accepting new patients
Pacific Vascular Incorporated CurrentSince Dec 14, 2021 Accepting new patients
Pacific Vascular Incorporated CurrentSince Dec 14, 2021 Accepting new patients
Pacific Vascular Incorporated CurrentSince Dec 1, 2025 Accepting new patients
Pacific Vascular Incorporated CurrentSince Dec 14, 2021 Accepting new patients
Providence Health & Services- Washington CurrentSince Sep 4, 2011 Accepting new patients
Pacific Vascular Incorporated CurrentSince Dec 14, 2021 Accepting new patients
Providence Health & Services-Wa Past Accepting new patients

Locations

1330 Rockefeller Ave
Ste 520
Everett, WA 98201
Phone (425) 297-5200

1321 Colby Ave
Ofc
Everett, WA 98201
Phone (425) 261-4076

4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 4

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": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423180800000",
    "number": "1215134697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "address_2": "PROVIDENCE HEALTH & SERVICES",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360",
            "telephone_number": "866-366-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 ROCKEFELLER",
            "address_2": "STE 520",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011677",
            "telephone_number": "425-297-5200",
            "fax_number": "425-297-5210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANT-ZAWADZKI",
        "first_name": "PETER",
        "middle_name": "BOLEK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-29",
        "last_updated": "2015-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "UT",
            "license": "54144231205",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "WA",
            "license": "MD60222893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.