Individual provider Active NPI

Alexander Victor Chaban, DO

  • Family Medicine Physician
  • Olympia, WA
National Provider Identifier
1235717166
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OL.61164283 Issued in WA
Practice address
525 Lilly Rd NE
Olympia, WA 98506-5101
Phone
(360) 493-4002
NPI assigned
Mar 31, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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 OL.61164283 WA Primary

Addresses

Primary practice location

525 Lilly Rd NE
Olympia, WA 98506-5101

Mailing address

525 Lilly Rd NE
Olympia, WA 98506-5101
Phone (360) 493-4002

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
I20240903001554 WA Practitioner - Family Practice 7719378165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Arizona College of Osteopathic Medicine Mid Western University, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health and Services WashingtonGroup PAC ID 6709782600, 480 clinicians

Practice addresses (Care Compare)

4800 College St SE
Lacey, WA 98503-4389
Phone (360) 486-2900

Hospital & facility affiliations

  • Assured Home Health and Hospice Home health agency, Centralia, WA, CCN 507042
  • Providence St Peter Hospital Hospital, Olympia, WA, CCN 500024
  • Providence Centralia Hospital Hospital, Centralia, WA, CCN 500019
  • Capital Medical Center Hospital, Olympia, WA, CCN 500139

Merit-based Incentive Payment System (MIPS)

Final score
96.26 of 100Reported as apm
Quality
84.3
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OL.61164283WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince Aug 1, 2024 Accepting new patients
Providence Health & Services Washington Family Medicine CurrentSince Aug 1, 2024 Accepting new patients

Locations

4800 College St SE
Olympia, WA 98503
Phone (360) 456-7575

525 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8550

Interoperability endpoints

  • Direct secure messaging: achaban1723010@wm.providencedirect.org

Organizations & group practices 2

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 5

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": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1235717166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065101",
            "telephone_number": "360-493-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065101",
            "telephone_number": "360-493-4002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHABAN",
        "first_name": "ALEXANDER",
        "middle_name": "VICTOR",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-31",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OL.61164283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.