Individual provider Active NPI

Sherri K Nevala III

  • Physician Assistant
  • Everett, WA
National Provider Identifier
1275603243
Registry record updated Jul 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10004039 Issued in WA
Practice address
3927 Rucker Ave
Everett, WA 98201-4833
Phone
(425) 339-5447
NPI assigned
Nov 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10004039 WA Primary

Addresses

Primary practice location

3927 Rucker Ave
Everett, WA 98201-4833

Mailing address

PO Box 5127
Everett, WA 98206-5127
Phone (425) 258-3900

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100319000204 WA Practitioner - Physician Assistant 5193850857 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Care Washington PLLCGroup PAC ID 6406752153, 684 clinicians

Practice addresses (Care Compare)

1330 Rockefeller Ave
Everett, WA 98201-1684
Phone (425) 259-0966

21601 76TH Ave W
Edmonds, WA 98026-7507
Phone (425) 640-4000

Hospital & facility affiliations

  • Swedish Edmonds Hospital Hospital, Edmonds, WA, CCN 500026

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Care Washington PLLC CurrentSince Feb 28, 2003 Accepting new patients
Optum Care Washington PLLC Current Accepting new patients
Optum Care Washington PLLC CurrentSince Feb 28, 2003 Accepting new patients
Optum Care Washington PLLC Past Accepting new patients

Locations

3927 Rucker Ave
Everett, WA 98201
Phone (425) 339-5419

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

1728 W Marine View Dr
Ste 111
Everett, WA 98201

3927 Rucker Ave
Ste 202
Everett, WA 98201

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

Interoperability endpoints

  • Direct secure messaging: snevala2142@direct.tecmc.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.

Hospital & facility affiliations 2

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405987200000",
    "number": "1275603243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5127",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982065127",
            "telephone_number": "425-258-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3927 RUCKER AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014833",
            "telephone_number": "425-339-5447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEVALA",
        "first_name": "SHERRI",
        "middle_name": "K",
        "name_suffix": "III",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2014-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10004039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.