Marina Park Plastics, PLLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

MARINA PARK PLASTICS, PLLC

Practice address

16 Central Way
Kirkland, WA 98033-6115

Phone

(425) 655-1200

NPI assigned

Aug 29, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Zachary P Joos, MDNPI 1588954119

Title

Owner

Phone

(425) 655-1200

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Marina Park Plastics, PLLC

  • Ambulatory Surgical Clinic/Center
  • Kirkland, WA
  • NPI 1619756350

  0345669248

  Same PAC ID

Tax ID family

Marina Park Plastics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Marina Park Plastics, PLLC

  • Ambulatory Surgical Clinic/Center
  • Kirkland, WA
  • NPI 1619756350
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Zachary Paul Joos, M.D.

  • Ophthalmology Physician
  • Kirkland, WA
  • NPI 1588954119
  Medicare reassignment NPD Authorized official
• Bryan Charles McIntosh, M.D.

  • Plastic Surgery Physician
  • Bellevue, WA
  • NPI 1982862165
  NPD (past)

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

{
    "created_epoch": "1598659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598659200000",
    "number": "1225641152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 CENTRAL WAY",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980336115",
            "telephone_number": "425-655-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 CENTRAL WAY",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980336115",
            "telephone_number": "425-655-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARINA PARK PLASTICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-29",
        "last_updated": "2020-08-29",
        "certification_date": "2020-08-29",
        "status": "A",
        "authorized_official_last_name": "JOOS",
        "authorized_official_first_name": "ZACHARY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-655-1200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1476308",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patrick Neal Marcus, MD
• Gerrie Margell
• Marianna Beetham, D.D.S., P.S.
• Angelika Mariano, RPH
• Aryana Maricle-Conroy
• Marina Park Plastics, PLLC
• Frank F Marinkovich, MD
• Mark G. Ochenrider, PLLC
• Mark J Cannon OD PS
• Mark J Pierce

• Medical Specialty Clinic/Center in Kirkland, WA
• Providers in Kirkland, WA by specialty
• Medical Specialty Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.