NPIMap

Individual provider Active NPI

Aaron B Clancy, PAC

  • Surgical Physician Assistant
  • Tacoma, WA
National Provider Identifier
1265735070
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA60193398 Issued in WA
Practice address
1802 Yakima Ave Ste 104
Tacoma, WA 98405-5303
Phone
(253) 426-6272
Fax
(253) 426-4060
NPI assigned
Dec 16, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Surgical Physician Assistant 363AS0400X PA60193398 WA Primary

Addresses

Primary practice location

1802 Yakima Ave Ste 104
Tacoma, WA 98405-5303

Mailing address

1802 Yakima Ave Ste 104
Tacoma, WA 98405-5303
Phone (253) 426-6272

Other identifiers 1

IdentifierTypeStateIssuer
2010498MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aclancy17142@fhsce.catholichealth.net Direct Franciscan Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110204000334 WA Practitioner - Physician Assistant 8325228505 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

1717 S J St
Tacoma, WA 98405-4933
Phone (253) 426-6341

1812 S J St
Suite 120
Tacoma, WA 98405-4965
Phone (253) 428-2200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA60193398WAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Jan 1, 2011 Accepting new patients
Franciscan Medical Group Physician Assistant CurrentSince Jan 1, 2025 Accepting new patients
Franciscan Medical Group CurrentSince Jan 1, 2025 Accepting new patients
Multicare Health System CurrentSince Jan 1, 2011 Accepting new patients
Franciscan Medical Group Physician Assistant Past Accepting new patients

Locations

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

315 S K St
Tacoma, WA 98405
Phone (253) 403-1291

1802 Yakima Ave
Ste 104
Tacoma, WA 98405
Phone (253) 426-6272

Organizations & group practices 7

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 3

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": "1292457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1265735070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1802 YAKIMA AVE STE 104",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055303",
            "telephone_number": "253-426-6272",
            "fax_number": "253-426-4060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 YAKIMA AVE STE 104",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984055303",
            "telephone_number": "253-426-6272",
            "fax_number": "253-426-4060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLANCY",
        "first_name": "AARON",
        "middle_name": "B",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-16",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA60193398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2010498",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aclancy17142@fhsce.catholichealth.net",
            "affiliation": "Y",
            "affiliationName": "Franciscan Medical Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1802 Yakima Ave Ste 104",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984055303",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.