Individual provider Active NPI

Michael Jacob Covington, DO

  • Family Medicine Physician
  • Yakima, WA
National Provider Identifier
1295359743
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP61278492 Issued in WA
Practice address
3907 Creekside Loop Ste 100
Yakima, WA 98902-4879
Phone
(509) 895-7535
Fax
(509) 895-7355
NPI assigned
Jun 1, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OP61278492 WA Primary

Addresses

Primary practice location

3907 Creekside Loop Ste 100
Yakima, WA 98902-4879

Mailing address

3907 Creekside Loop Ste 100
Yakima, WA 98902-4879
Phone (509) 895-7535

Other identifiers 1

IdentifierTypeStateIssuer
2160223MedicaidWA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230912003129 WA Practitioner - Family Practice 0042634834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Covington Clinic PCGroup PAC ID 2668787078, 2 clinicians

Practice addresses (Care Compare)

3902 Creekside Loop
Suite 110
Yakima, WA 98902-4876
Phone (509) 895-7535

3907 Creekside Loop
Suite 100
Yakima, WA 98902-4879

Hospital & facility affiliations

  • Memorial Home Care Services Home health agency, Yakima, WA, CCN 507028
  • Mountainview Home Health Home health agency, Yakima, WA, CCN 507115
  • Yakima Valley Memorial Hospital, Yakima, WA, CCN 500036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OP61278492WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Covington Clinic P.C. Family Medicine CurrentSince Aug 14, 2023 Accepting new patients

Locations

3902 Creekside Loop
Ste 110
Yakima, WA 98902
Phone (509) 215-5946

3907 Creekside Loop
Ste 100
Yakima, WA 98902
Phone (509) 457-1900

Interoperability endpoints

  • FHIR API: https://drchrono-fhirpresentation.everhealthsoftware.com/fhir/drchrono/496993/r4

Organizations & group practices 1

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": "1590969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1295359743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3907 CREEKSIDE LOOP STE 100",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989024879",
            "telephone_number": "509-895-7535",
            "fax_number": "509-895-7355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3907 CREEKSIDE LOOP STE 100",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989024879",
            "telephone_number": "509-895-7535",
            "fax_number": "509-895-7355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COVINGTON",
        "first_name": "MICHAEL",
        "middle_name": "JACOB",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-01",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP61278492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2160223",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.