Active NPI
Thomas B Vader, MD
- Anesthesiology Physician
- Coupeville, WA
National Provider Identifier
1285726307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- MD00015541
- Practice address
- 101 N Main St
Whidbey General Hospital
Coupeville, WA 98239 - Phone
- (360) 678-6018
- NPI assigned
- Sep 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | MD00015541 | WA | Primary |
Addresses
Primary practice location
101 N Main St
Whidbey General Hospital
Coupeville, WA 98239
Mailing address
P O Box 129
Coupeville, WA 98239
Phone (360) 678-4071
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15522 | Other | WA | REGENCE BLUE SHIELD |
| 1124403 | Medicaid | WA | |
| 0015292 | Other | WA | DLI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00015541 | WA | MD | Anesthesiology Physician |
| 025209 | WA | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| E Christopher Outlund MD PC | Past | Accepting new patients | |
| Nicholas S Muff MD PS | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Specialist
- Coupeville, WA
- NPI 1962699827
-
- Specialist
- Sedro Woolley, WA
- NPI 1245325950
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199750400000",
"number": "1285726307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P O BOX 129",
"city": "COUPEVILLE",
"state": "WA",
"postal_code": "98239",
"telephone_number": "360-678-4071",
"fax_number": "360-678-6014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 N MAIN ST",
"address_2": "WHIDBEY GENERAL HOSPITAL",
"city": "COUPEVILLE",
"state": "WA",
"postal_code": "98239",
"telephone_number": "360-678-6018"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VADER",
"first_name": "THOMAS",
"middle_name": "B",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-28",
"last_updated": "2008-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "WA",
"license": "MD00015541",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD",
"identifier": "15522",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1124403",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DLI",
"identifier": "0015292",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Coupeville, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.