NPIMap

Organization Active NPI

Public Hospital Dist No 1 Skagit

Doing business as Skagit Regional Health Arlington Orthopedics and Sports Medicine

  • Orthopaedic Surgery Physician
  • Arlington, WA
National Provider Identifier
1295774016
Registry record updated Dec 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
HAC.FS.00000106 Issued in WA
Legal business name
PUBLIC HOSPITAL DIST NO 1 SKAGIT
Doing business as
Skagit Regional Health Arlington Orthopedics and Sports Medicine
Practice address
328 S. Stillaguamish Ave.
Arlington, WA 98223-1660
Phone
(360) 435-6641
Fax
(360) 618-7663
NPI assigned
Jun 6, 2006
Last updated
Dec 10, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2018

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

Authorized official

Name
Paul Ishizuka
Title
Chief Financial Officer
Phone
(360) 814-5838

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X HAC.FS.00000106 WA Primary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X
Foot & Ankle Surgery Podiatrist 213ES0103X

Addresses

Primary practice location

328 S. Stillaguamish Ave.
Arlington, WA 98223-1660

Mailing address

1400 E. Kincaid Street
Attn: Credentialing
Mount Vernon, WA 98274-4127
Phone (360) 814-6724

Other identifiers 1

IdentifierTypeStateIssuer
2058830MedicaidWA

Other names 2

  • Skagit Regional Health Arlington Orthopedics and Sports Medicine Doing business as
  • Skagit Regional Health Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040309001059 WA Part B Supplier - Clinic/Group Practice 6800793522 Receives reassigned benefits from 550 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Mount Vernon, WA; Oak Harbor, WA; Anacortes, WA; Stanwood, WA; Arlington, WA; Camano Island, WA; Darrington, WA; Everett, WA…

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

819 S 13th St
Mount Vernon, WA 98274
Phone (360) 336-9757

Practitioners & affiliated clinicians

Practitioners 59

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 59

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544400000000",
    "number": "1295774016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E. KINCAID STREET",
            "address_2": "ATTN: CREDENTIALING",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744127",
            "telephone_number": "360-814-6724",
            "fax_number": "360-428-6485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328 S. STILLAGUAMISH AVE.",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982231660",
            "telephone_number": "360-435-6641",
            "fax_number": "360-618-7663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUBLIC HOSPITAL DIST NO 1 SKAGIT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-06",
        "last_updated": "2018-12-10",
        "status": "A",
        "authorized_official_last_name": "ISHIZUKA",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "360-814-5838"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WA",
            "license": "HAC.FS.00000106",
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2058830",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Skagit Regional Health Arlington Orthopedics and Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Skagit Regional Health Arlington Orthopedics and Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Skagit Regional Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Arlington, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2018; 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.