Bennett Wayne Pafford, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD61304014 Issued in WA

Practice address

528 Myrtle Street
La Conner, WA 98257

Phone

(360) 446-3136

Fax

(360) 466-0107

NPI assigned

Jun 16, 2009

Last updated

May 23, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Internal Medicine

Education

East Tennessee State University Quillen College of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians

Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Optum Care Washington PLLC

  • Multi-Specialty Clinic/Center
  • Everett, WA
  • NPI 1831186766

  Family Medicine

  Medicare reassignment NPD
• Select Rehabilitation, LLC

  • Rehabilitation Clinic/Center
  • Glenview, IL
  • NPI 1346368248
  Care Compare group
• Optum Care Washington PLLC

  • Durable Medical Equipment & Medical Supplies
  • Marysville, WA
  • NPI 1194428425

  Family Medicine

  NPD
• Optum Care Washington PLLC

  • Ambulatory Surgical Clinic/Center
  • Arlington, WA
  • NPI 1366154304
  NPD
• Wyoming Medical Associates, LLC

  • Clinic/Center
  • Gillette, WY
  • NPI 1114531118
  NPD

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1255568366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5127",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982065127",
            "telephone_number": "254-258-3900",
            "fax_number": "760-873-3951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528 MYRTLE STREET",
            "city": "LA CONNER",
            "state": "WA",
            "postal_code": "98257",
            "telephone_number": "360-446-3136",
            "fax_number": "360-466-0107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAFFORD",
        "first_name": "BENNETT",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-16",
        "last_updated": "2024-05-23",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD61304014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Miller, ARNP, FNP-C
• Lindsey Monica Montileaux Mabbutt, DDS, MPH
• Thanh Nguyen
• Leah Reiko Nystrom
• Optum Care Washington PLLC
• Reidun E Pederson, RN
• Rene Amelia Pinkham, LMP MA 60485559
• Pure Joy Naturopathic Medicine
• Larry Joseph Quesnell, D.D.S.
• Yolanda Grado Quevedo, PH.D., LMHC

• Internal Medicine Physician in La Conner, WA
• Providers in La Conner, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.