Individual provider Active NPI

Brandon Bruce Mascott, PA

  • Physician Assistant
  • Vancouver, WA
National Provider Identifier
1275910929
Registry record updated Oct 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
16811 SE McGillivray Blvd # 101
Vancouver, WA 98683-3404
Phone
(360) 735-8100
NPI assigned
May 1, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2015

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 Primary

Addresses

Primary practice location

16811 SE McGillivray Blvd # 101
Vancouver, WA 98683-3404

Mailing address

16811 SE McGillivray Blvd
Vancouver, WA 98683-3404
Phone (360) 735-8100

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
I20150722004235 WA Practitioner - Physician Assistant 6608189436 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Peacehealth 245 clinicians

Practice addresses (Care Compare)

16811 SE McGillivray Blvd
Vancouver, WA 98683-3404
Phone (360) 735-8100

505 NE 87TH Ave
Vancouver, WA 98664-1965

Hospital & facility affiliations

  • Peacehealth Southwest Home Health Home health agency, Vancouver, WA, CCN 507064
  • Peacehealth Southwest Medical Cente Hospital, Vancouver, WA, CCN 500050

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth CurrentSince Aug 24, 2015 Accepting new patients
Southwest Washington Medical Center Past Accepting new patients

Locations

16811 SE McGillivray Blvd
Vancouver, WA 98683
Phone (360) 514-4900

16811 SE McGillivray Blvd
#101
Vancouver, WA 98683
Phone (360) 735-8100

1115 SE 164th Ave
Dept 364
Vancouver, WA 98683
Phone (360) 735-8100

505 NE 87th Ave
Ste 301
Vancouver, WA 98664
Phone (360) 514-1854

9330 NE Vancouver Mall Dr
Ste 100
Vancouver, WA 98662
Phone (360) 729-8510

Interoperability endpoints

  • Direct secure messaging: bmascott119785@direct.peacehealth.org

Organizations & group practices 3

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": "1430438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446163200000",
    "number": "1275910929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16811 SE MCGILLIVRAY BLVD",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986833404",
            "telephone_number": "360-735-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16811 SE MCGILLIVRAY BLVD # 101",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986833404",
            "telephone_number": "360-735-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASCOTT",
        "first_name": "BRANDON",
        "middle_name": "BRUCE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-01",
        "last_updated": "2015-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.