Michael Stephen Chisum, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD61170311 Issued in WA

Practice address

751 NE Blakely Dr Ste 4020
Issaquah, WA 98029-6201

Phone

(425) 313-7124

Fax

(425) 313-7072

NPI assigned

Mar 26, 2017

Last updated

Dec 1, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

General Surgery

Education

University of Florida College of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Swedish Health ServicesGroup PAC ID 0244138196, 1,038 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Swedish Issaquah Hospital, Issaquah, WA, CCN 500152

Merit-based Incentive Payment System (MIPS)

Final score

87.1 of 100Reported as group

Quality

84.53

Promoting interoperability

100

Improvement activities

40

Cost

72.46

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Swedish Health Services

  • Internal Medicine Physician
  • Seattle, WA
  • NPI 1689612954

  Surgery

  Medicare reassignment Care Compare group NPD
• Swedish Health Services

  dba Swedish Physician Division

  • Surgery Physician
  • Seattle, WA
  • NPI 1053368571
  NPD (past)
• Swedish Health Services

  dba Swedish/Issaquah

  • General Acute Care Hospital
  • Issaquah, WA
  • NPI 1851686059
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Swedish Health Services

  dba Swedish/Issaquah

  • General Acute Care Hospital
  • Issaquah, WA
  • NPI 1851686059
  Care Compare affiliation

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

{
    "created_epoch": "1490486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669852800000",
    "number": "1265963771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 NE BLAKELY DR STE 4020",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980296201",
            "telephone_number": "425-313-7124",
            "fax_number": "425-313-7072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHISUM",
        "first_name": "MICHAEL",
        "middle_name": "STEPHEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-26",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD61170311",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2084042",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• CHI DDS PLLC
• Colbi Russell Childs, SUDPT
• Erin Childs, LMT, MMP
• Chiro One Wellness Center of Issaquah PLLC
• Keya Chisholm, FNP-C
• Phoebe Chitila James, NP
• David Y Choe, D.C.
• Myung Soo Choi, DPT
• Jake Harley Choiniere, DO
• Naomi D Chou, MD

• Surgery Physician in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; 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.