Orchard Medical Clinic

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

MD000380965 Issued in WA

Legal business name

ORCHARD MEDICAL CLINIC

Practice address

5320 Orchard St W
University Place, WA 98467-3633

Phone

(253) 474-7100

Fax

(253) 474-2677

NPI assigned

Jan 27, 2012

Organization subpart

Yes

Parent organization

ORCHARD MEDICAL CLINICAs reported in NPPES

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

Authorized official

Name

Dr. Glenn A Pacio, M.D.NPI 1497755268

Title

Owner

Phone

(253) 474-7100

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• GLENN A. PACIO Other name

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Part of

Orchard Medical Clinc

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Orchard Medical Clinic

  • Internal Medicine Physician
  • University Place, WA
  • NPI 1770751083
  NPPES parent name

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Glenn Amante Pacio, MD

  • Internal Medicine Physician
  • Lakewood, WA
  • NPI 1497755268
  Medicare reassignment Authorized official
• Peter P Bingcang, MD

  • Psychiatry Physician
  • Auburn, WA
  • NPI 1639179401
  NPD (past)
• Julio F Buenaventura, MD

  • Internal Medicine Physician
  • Lakewood, WA
  • NPI 1477553246
  NPD (past)
• Nitin M Karnik, MD

  • Psychiatry Physician
  • Yakima, WA
  • NPI 1205836475
  NPD (past)
• Yajun Liu

  • Internal Medicine Physician
  • Tacoma, WA
  • NPI 1750350088
  NPD (past)
• Romeo Sison Puzon, MD

  • General Practice Physician
  • Lakewood, WA
  • NPI 1538190608
  NPD (past)
• Mohebat Sabeti, MD

  • Psychiatry Physician
  • University Place, WA
  • NPI 1932109709
  NPD (past)

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

{
    "created_epoch": "1327622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329350400000",
    "number": "1255603874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7501 92ND AVENUE CT SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984983973",
            "telephone_number": "253-588-0058",
            "fax_number": "253-589-4862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5320 ORCHARD ST W",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984673633",
            "telephone_number": "253-474-7100",
            "fax_number": "253-474-2677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORCHARD MEDICAL CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ORCHARD MEDICAL CLINIC",
        "enumeration_date": "2012-01-27",
        "last_updated": "2012-02-16",
        "status": "A",
        "authorized_official_last_name": "PACIO",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-474-7100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "WA",
            "license": "MD000380965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11155922",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH",
            "identifier": "711938001",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICAARE",
            "identifier": "P00850060",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GLENN A. PACIO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ohana Primary&Wound Clinic
• Curt James Oland, OD
• Madeline Oleary, OTR/L
• Hannah Olver
• Yana Onishchenko, COTA/L
• Orchard Medical Clinic
• Johnathan Taylor Ordway
• Michael G. Orr
• Debora W Overstreet, MD
• Pacheco & Henry DDS PS (Bridgeport Family Dentistry)

• Medical Specialty Clinic/Center in University Place, WA
• Providers in University Place, WA by specialty
• Medical Specialty Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.