Individual provider Active NPI

Ethan M Angell, MD

  • Family Medicine Physician
  • Spokane, WA
National Provider Identifier
1265490247
Registry record updated Dec 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00043875 Issued in WA
Practice address
3919 N Maple St
Spokane, WA 99205-1349
Phone
(509) 444-7801
Fax
(509) 444-7807
NPI assigned
May 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2015

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 MD00043875 WA Primary

Addresses

Primary practice location

3919 N Maple St
Spokane, WA 99205-1349

Mailing address

203 N Washington St
Suite 300
Spokane, WA 99201-0233
Phone (509) 444-8888

Other identifiers 1

IdentifierTypeStateIssuer
8400285MedicaidWA

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
I20040915000565 WA Practitioner - Family Practice 3678540911 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Oregon Health Sciences University School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Association of SpokaneGroup PAC ID 9638063217, 222 clinicians

Practice addresses (Care Compare)

1001 W 2ND Ave
Spokane, WA 99201-4503
Phone (509) 835-1206

3919 N Maple St
Spokane, WA 99205-1349
Phone (509) 444-8888

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00043875WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Association of Spokane CurrentSince Aug 16, 2004 Accepting new patients
Community Health Association of Spokane Current Accepting new patients
Community Health Association of Spokane Family Medicine CurrentSince Aug 16, 2004 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

803 S Main St
Ste 120
Moscow, ID 83843
Phone (208) 848-8300

1720 2nd St
Cheney, WA 99004
Phone (207) 865-8002

5921 N Market St
Spokane, WA 99208
Phone (509) 487-1604

1001 W 2nd Ave
Spokane, WA 99201
Phone (509) 835-1205

203 N Washington St
Ste 300
Spokane, WA 99201

914 W Carlisle Ave
Spokane, WA 99205
Phone (509) 325-0393

5620 S Regal St
Ste 11
Spokane, WA 99223
Phone (509) 340-1590

3919 N Maple St
Spokane, WA 99205
Phone (509) 326-6900

1502 N Vercler Rd
Spokane Valley, WA 99216
Phone (509) 444-8204

Interoperability endpoints

  • Direct secure messaging: ethan.angell.1@11411.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451433600000",
    "number": "1265490247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 N WASHINGTON ST",
            "address_2": "SUITE 300",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992010233",
            "telephone_number": "509-444-8888",
            "fax_number": "509-444-7806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3919 N MAPLE ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992051349",
            "telephone_number": "509-444-7801",
            "fax_number": "509-444-7807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGELL",
        "first_name": "ETHAN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2015-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00043875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8400285",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.