Individual provider Active NPI

Michael A Welsh, MD

  • Family Medicine Physician
  • Buckley, WA
National Provider Identifier
1235122763
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
26055 Issued in WA
Practice address
305 N River Ave
Buckley, WA 98321-8978
Phone
(360) 829-0625
Fax
(360) 829-9860
NPI assigned
Aug 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 26055 WA Primary

Addresses

Primary practice location

305 N River Ave
Buckley, WA 98321-8978

Mailing address

PO Box 1268
Buckley, WA 98321-1268
Phone (360) 829-0625

Other identifiers 1

IdentifierTypeStateIssuer
1300979MedicaidWA

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
I20100430000463 WA Practitioner - Family PracticePractitioner - General Practice 7214929405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: General Practice
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
White River Family Care LLCGroup PAC ID 1254323447, 3 clinicians

Practice addresses (Care Compare)

305 N River Ave
Buckley, WA 98321-8978
Phone (360) 829-0625

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26055WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
White River Family Care LLC Family Medicine CurrentSince Jan 1, 2003 Accepting new patients

Organizations & group practices 1

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 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": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1235122763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1268",
            "city": "BUCKLEY",
            "state": "WA",
            "postal_code": "983211268",
            "telephone_number": "360-829-0625",
            "fax_number": "360-829-9860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 N RIVER AVE",
            "city": "BUCKLEY",
            "state": "WA",
            "postal_code": "983218978",
            "telephone_number": "360-829-0625",
            "fax_number": "360-829-9860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELSH",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "26055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1300979",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Buckley, WA

Sources for this page

Verify at the official NPI Registry.