Songyan Mao, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD60656516 Issued in WA

Practice address

12800 Bothell Everett Hwy
Everett, WA 98208

Phone

(425) 316-5150

Fax

(425) 316-5153

NPI assigned

Jul 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN, WA2 enrollments

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 2

Specialty

Family Practice

Education

Other, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Services- WashingtonGroup PAC ID 8325100480, 527 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Regional Medical Center Everett Hospital, Everett, WA, CCN 500014

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Providence Health & Services- Washington

  • General Practice Physician
  • Everett, WA
  • NPI 1124270715
  Medicare reassignment Care Compare group NPD
• Swedish Health Services

  • Family Medicine Physician
  • Seattle, WA
  • NPI 1831139724
  Medicare reassignment NPD
• Community Medical Associates, Inc.

  • Internal Medicine Physician
  • Louisville, KY
  • NPI 1588614994

  Family Medicine, IN

  Medicare reassignment NPD
• Providence Health & Services - Wa

  • General Practice Physician
  • Mukilteo, WA
  • NPI 1003050709

  Family Medicine

  NPD
• Swedish Health Services

  • Family Medicine Physician
  • Seattle, WA
  • NPI 1073553947
  NPD
• Swedish Health Services

  • Physical Therapist
  • Seattle, WA
  • NPI 1619680840
  NPD
• Community Medical Associates, Inc.

  • Neurological Surgery Physician
  • Louisville, KY
  • NPI 1922288760
  NPD
• Scott Physician Group LLC

  • Orthopaedic Surgery Physician
  • Scottsburg, IN
  • NPI 1952639890
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Health & Services-Wa

  • Hospitalist Physician
  • Everett, WA
  • NPI 1649615220
  Care Compare affiliation
• Providence Health & Services-Wa

  • General Acute Care Hospital
  • Everett, WA
  • NPI 1700037801
  Care Compare affiliation

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1235160474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360",
            "telephone_number": "866-747-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12800 BOTHELL EVERETT HWY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "98208",
            "telephone_number": "425-316-5150",
            "fax_number": "425-316-5153"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1930 Bishop Ln",
            "address_2": "Suite 1600",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402181921",
            "country_code": "US",
            "telephone_number": "502-272-5034",
            "fax_number": "502-272-5117",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1930 Bishop Ln",
            "address_2": "Suite 1600",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402181921",
            "country_code": "US",
            "telephone_number": "502-272-5034",
            "fax_number": "502-272-5117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAO",
        "first_name": "SONGYAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "40682",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60656516",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200864900",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SIHO",
            "identifier": "090199",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE - NICC",
            "identifier": "P00415227",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE - NICC",
            "identifier": "P00838106",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM FOR NICC",
            "identifier": "000000482470",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smao638062@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "12800 Bothell Everett Hwy",
            "city": "Everett",
            "state": "WA",
            "country_code": "US",
            "postal_code": "98208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Britni Tyne Manos, COTA/L
• Tiffany Manrique
• Nicole Ann Mansfield, MHT3
• Lisa K Mantle, OTR
• Ashley Marie Manzoni, B.A./A.A.C.
• Hanna Maple-Lelle
• Anna Maracich, BS, AAC
• Mara Marano-Bianco, RN; BSCN
• Eileen R Marasigan, RDH
• Nicholas Marassi, MD

• Family Medicine Physician in Everett, WA
• Providers in Everett, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.