NPIMap

Organization Active NPI

Fourth Corner Neurosurgical Associates Inc PS

  • Ambulatory Surgical Clinic/Center
  • Bellingham, WA
National Provider Identifier
1275938102
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
FOURTH CORNER NEUROSURGICAL ASSOCIATES INC PS
Practice address
710 Birchwood Ave
Suite 101
Bellingham, WA 98225-1720
Phone
(360) 676-0922
NPI assigned
Nov 4, 2014
Organization subpart
Yes
Parent organization
FOURTH CORNER NEUROSURGICAL ASSOCIATESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Authorized official

Name
Dr. Tung Ha, D.O.NPI 1902020738
Title
Medical Director
Phone
(360) 676-0922

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

710 Birchwood Ave
Suite 101
Bellingham, WA 98225-1720

Mailing address

710 Birchwood Ave Ste 103
Bellingham, WA 98225-1720
Phone (360) 527-0404

Other names 1

  • Cascade Outpatient Spine Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160706002786 WA Part B Supplier - Ambulatory Surgical Center 1557250248 Receives reassigned benefits from 3 practitioners
Practice locations: Bellingham, WA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Fourth Corner Neurosurgical Associates Inc PS Dba Cascade Outpatient Spine CenterCCN 50C0001317
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Part of
Fourth Corner Neurosurgical

Locations

710 Birchwood Ave
Ste 103
Bellingham, WA 98225
Phone (360) 527-0404

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1415059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656979200000",
    "number": "1275938102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 BIRCHWOOD AVE STE 103",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251720",
            "telephone_number": "360-527-0404",
            "fax_number": "360-527-0407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 BIRCHWOOD AVE",
            "address_2": "SUITE 101",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251720",
            "telephone_number": "360-676-0922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOURTH CORNER NEUROSURGICAL ASSOCIATES INC PS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FOURTH CORNER NEUROSURGICAL ASSOCIATES",
        "enumeration_date": "2014-11-04",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A",
        "authorized_official_last_name": "HA",
        "authorized_official_first_name": "TUNG",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "360-676-0922",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cascade Outpatient Spine Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cascade Outpatient Spine Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.