Individual provider Active NPI

Vitaliy Berezhnoy, PA-C

  • Medical Physician Assistant
  • Port Townsend, WA
National Provider Identifier
1235465345
Registry record updated Oct 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA60115672 Issued in WA
Practice address
834 Sheridan St
Port Townsend, WA 98368-2443
Phone
(360) 385-2200
Fax
(360) 344-0411
NPI assigned
Oct 23, 2009
Last updated
Oct 23, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA60115672 WA Primary

Addresses

Primary practice location

834 Sheridan St
Port Townsend, WA 98368-2443

Mailing address

20123 Sunnyside Dr N Apt D301
Shoreline, WA 98133-2749

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091222000169 WA Practitioner - Physician Assistant 6507906690 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Sound Emergency Physicians PLLCGroup PAC ID 9234133703, 30 clinicians
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

1800 NW Myhre Rd
Silverdale, WA 98383-7663
Phone (360) 337-8800

1812 S J St
Suite 120
Tacoma, WA 98405-4965
Phone (253) 428-2200

2520 Cherry Ave
Bremerton, WA 98310-4229
Phone (360) 792-6710

4205 Kitsap Way
Bremerton, WA 98312-2447
Phone (360) 782-7780

4207 Kitsap Way
Bremerton, WA 98312-2447
Phone (360) 415-1080

450 S Kitsap Blvd
Suite 100
Port Orchard, WA 98366-3709
Phone (360) 895-7620

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.1 of 100Reported as group
Quality
72.48
Improvement activities
40
Cost
80.79

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince Mar 5, 2025 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Sep 17, 2017 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Sep 17, 2017 Accepting new patients
Franciscan Medical Group CurrentSince Mar 5, 2025 Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

2520 Cherry Ave
Bremerton, WA 98310
Phone (360) 377-3911

4205 Kitsap Way
Bremerton, WA 98312
Phone (360) 782-7780

450 S Kitsap Blvd
Ste 100
Port Orchard, WA 98366
Phone (360) 744-6275

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

10452 Silverdale Way NW
Silverdale, WA 98383
Phone (360) 307-7300

1800 NW Myhre Rd
Silverdale, WA 98383
Phone (360) 337-8800

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1256256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256256000000",
    "number": "1235465345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20123 SUNNYSIDE DR N APT D301",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981332749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "834 SHERIDAN ST",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983682443",
            "telephone_number": "360-385-2200",
            "fax_number": "360-344-0411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEREZHNOY",
        "first_name": "VITALIY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-23",
        "last_updated": "2009-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA60115672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Townsend, WA

Sources for this page

Verify at the official NPI Registry.