NPIMap

Organization Active NPI

Northwest Surgical Specialists PC

  • Durable Medical Equipment & Medical Supplies
  • Vancouver, WA
National Provider Identifier
1306368915
Registry record updated Jul 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
NORTHWEST SURGICAL SPECIALISTS PC
Practice address
2121 NE 139TH St Ste 300
Vancouver, WA 98686-2316
Phone
(360) 254-6161
Fax
(360) 449-1146
NPI assigned
Jul 14, 2017
Organization subpart
Yes
Parent organization
NORTHWEST SURGICAL SPECIALISTS PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 14, 2017

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

Authorized official

Name
Jay L Crary, MDNPI 1700821253
Title
Authorized Official
Phone
(360) 254-6161

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
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

2121 NE 139TH St Ste 300
Vancouver, WA 98686-2316

Mailing address

200 NE Mother Joseph PL Ste 210
Vancouver, WA 98664-3295
Phone (360) 254-6161

Other names 1

  • Rebound Orthopedic and Neurosurgery Salmon Creek Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180411000883 WA DME Supplier - Physician - Orthopedic/Orthopedic Surgery 4183527153 Practice locations: Vancouver, WA

Other NPIs with the same Medicare PAC ID 7

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

National Provider Directory

National Provider Directory
Tax ID family
NW Surgical Specialists5 organizations share this tax ID, including this one
Part of
NW Surgical Specialists

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2121 NE 139th St
Ste 300
Vancouver, WA 98686

200 NE Mother Joseph Pl
Ste 210
Vancouver, WA 98664
Phone (360) 449-1145

Practitioners & affiliated clinicians

Practitioners 118

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

View all 118

NPI Registry JSON

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

{
    "created_epoch": "1499990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499990400000",
    "number": "1306368915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NE MOTHER JOSEPH PL STE 210",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643295",
            "telephone_number": "360-254-6161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 NE 139TH ST STE 300",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986862316",
            "telephone_number": "360-254-6161",
            "fax_number": "360-449-1146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST SURGICAL SPECIALISTS PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHWEST SURGICAL SPECIALISTS PC",
        "enumeration_date": "2017-07-14",
        "last_updated": "2017-07-14",
        "status": "A",
        "authorized_official_last_name": "CRARY",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "360-254-6161",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rebound Orthopedic and Neurosurgery Salmon Creek",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2017; 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.