Individual provider Active NPI

Philip R Yearian, DPM

  • Podiatrist
  • Lakewood, WA
National Provider Identifier
1255307807
Registry record updated Jan 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
P000000535 Issued in WA
Practice address
7308 Bridgeport Way W
Suite 201
Lakewood, WA 98499-8000
Phone
(253) 582-7257
Fax
(253) 582-1617
NPI assigned
Feb 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X P000000535 WA Primary

Addresses

Primary practice location

7308 Bridgeport Way W
Suite 201
Lakewood, WA 98499-8000

Mailing address

805 Madison St
Suite 901
Seattle, WA 98104-1172
Phone (206) 264-8100

Other identifiers 2

IdentifierTypeStateIssuer
346704OtherWAWA STATE LNI
1005973MedicaidWA

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031210000197 WA Practitioner - Podiatry 5092611327 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proliance Surgeons Inc P SGroup PAC ID 8527972900, 395 clinicians

Practice addresses (Care Compare)

7308 Bridgeport Way W
Suite 201
Lakewood, WA 98499-8000
Phone (253) 582-7257

Hospital & facility affiliations

  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129
  • St Anthony Hospital Hospital, Gig Harbor, WA, CCN 500151

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue268
Removal of skin lesions1-10
Removal of nail tissue436
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P000000535WAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc P S Current Accepting new patients
Proliance Surgeons Inc P S CurrentSince Jan 1, 2016 Accepting new patients
Proliance Surgeons, Inc., P.S. CurrentSince Jan 1, 2016 Accepting new patients
Philip R. Yearian DPM PS PastSince Aug 1, 2003 Accepting new patients
Proliance Surgeons, Inc., P.S. Past Accepting new patients
Tacoma Orthopaedic Surgeons Inc Past Accepting new patients

Locations

2727 Hollycroft St
Ste 410
Gig Harbor, WA 98335
Phone (253) 358-4002

7308 Bridgeport Way W
Ste 201
Lakewood, WA 98499
Phone (253) 582-7257

1401 S Laventure Rd
Mount Vernon, WA 98274
Phone (360) 424-2400

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

Interoperability endpoints

  • Direct secure messaging: philip.yearian.p73@direct.proliance.nextgenshare.com
  • Direct secure messaging: pyearian29454@fhsce.catholichealth.net

Organizations & group practices 6

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 2

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": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451952000000",
    "number": "1255307807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 MADISON ST",
            "address_2": "SUITE 901",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041172",
            "telephone_number": "206-264-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7308 BRIDGEPORT WAY W",
            "address_2": "SUITE 201",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984998000",
            "telephone_number": "253-582-7257",
            "fax_number": "253-582-1617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEARIAN",
        "first_name": "PHILIP",
        "middle_name": "R",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2016-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WA",
            "license": "P000000535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA STATE LNI",
            "identifier": "346704",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1005973",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

Verify at the official NPI Registry.