NPIMap

Organization Active NPI

Public Hospital Dist No 1 Skagit

Doing business as Cascade Valley Hospital Physicians

  • Anesthesiology Physician
  • Arlington, WA
National Provider Identifier
1265791065
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
00000106 Issued in WA
Legal business name
PUBLIC HOSPITAL DIST NO 1 SKAGIT
Doing business as
Cascade Valley Hospital Physicians
Practice address
330 S Stillaguamish Ave
Arlington, WA 98223-1642
Phone
(360) 435-2133
Fax
(360) 435-0513
NPI assigned
May 14, 2012
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Paul Ishizuka
Title
Chief Financial Officer
Phone
(360) 814-5838

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X 00000106 WA Primary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X 00000106 WA
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 00000106 WA
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X HAC.FS.00000106 WA
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X 000000106 WA

Addresses

Primary practice location

330 S Stillaguamish Ave
Arlington, WA 98223-1642

Mailing address

1400 E Kincaid St
Attn: Credentialing
Mount Vernon, WA 98274-4127
Phone (360) 428-2500

Other practice location 1

875 Wesley St Ste 150
Arlington, WA 98223-1613
Phone (360) 435-6969

Other identifiers 2

IdentifierTypeStateIssuer
355079OtherWALABOR & INDUSTRIES
2061042MedicaidWA

Other names 1

  • Cascade Valley Hospital Physicians Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040309001059 WA Part B Supplier - Clinic/Group Practice 6800793522 Receives reassigned benefits from 550 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mount Vernon, WA; Oak Harbor, WA; Anacortes, WA; Stanwood, WA; Arlington, WA; Camano Island, WA; Darrington, WA; Everett, WA…

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Skagit Valley Hospital26 organizations share this tax ID, including this one

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Locations

875 Wesley St
Ste 150
Arlington, WA 98223
Phone (360) 435-6969

405 W Stanley St
Granite Falls, WA 98252
Phone (360) 619-2419

901 S 5th St
Mount Vernon, WA 98274
Phone (360) 428-6434

Practitioners & affiliated clinicians

Practitioners 64

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 64

NPI Registry JSON

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

{
    "created_epoch": "1336953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1265791065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E KINCAID ST",
            "address_2": "ATTN: CREDENTIALING",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744127",
            "telephone_number": "360-428-2500",
            "fax_number": "360-428-6485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 S STILLAGUAMISH AVE",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982231642",
            "telephone_number": "360-435-2133",
            "fax_number": "360-435-0513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "875 Wesley St Ste 150",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "WA",
            "postal_code": "982231613",
            "country_code": "US",
            "telephone_number": "360-435-6969",
            "fax_number": "360-435-0513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PUBLIC HOSPITAL DIST NO 1 SKAGIT",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-14",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "ISHIZUKA",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "360-814-5838"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "00000106",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "WA",
            "license": "00000106",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "00000106",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": "WA",
            "license": "HAC.FS.00000106",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "000000106",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "355079",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2061042",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cascade Valley Hospital Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Arlington, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.