Organization Active NPI

Dr RVC PLLC

Doing business as Medcare Clinics

  • Preferred Provider Organization
  • Issaquah, WA
National Provider Identifier
1285051086
Registry record updated Jan 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
License
MD00031289 Issued in WA
Legal business name
DR RVC PLLC
Doing business as
Medcare Clinics
Practice address
1301 4TH Ave NW Ste 204
Issaquah, WA 98027-9371
Phone
(425) 557-4227
Fax
(425) 557-2858
NPI assigned
Mar 19, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2023

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

Authorized official

Name
Dr. Reinier Van Coevorden
Title
MD
Phone
(425) 557-4227

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X MD00031289 WA Primary

Addresses

Primary practice location

1301 4TH Ave NW Ste 204
Issaquah, WA 98027-9371

Mailing address

1490 NW Gilman Blvd
Issaquah, WA 98027-5498
Phone (425) 557-4227

Other names 1

  • Medcare Clinics Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140422000343 WA Part B Supplier - Clinic/Group Practice 1456583657 Receives reassigned benefits from 1 practitioner
Practice locations: Issaquah, WA

National Provider Directory

National Provider Directory

Locations

1301 4th Ave NW
Ste 204
Issaquah, WA 98027
Phone (425) 557-4227

Practitioners & affiliated clinicians

Practitioners 4

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": "1395187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674864000000",
    "number": "1285051086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1490 NW GILMAN BLVD",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980275498",
            "telephone_number": "425-557-4227",
            "fax_number": "425-557-2858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 4TH AVE NW STE 204",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980279371",
            "telephone_number": "425-557-4227",
            "fax_number": "425-557-2858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR RVC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-19",
        "last_updated": "2023-01-28",
        "certification_date": "2023-01-28",
        "status": "A",
        "authorized_official_last_name": "VAN COEVORDEN",
        "authorized_official_first_name": "REINIER",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "425-557-4227",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "WA",
            "license": "MD00031289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medcare Clinics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Medcare Clinics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2023; 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.