NPIMap

Organization Active NPI

J. Hamilton Licht, M.D., P.C.

Doing business as Nephrology Associates of Yakima

  • Nephrology Physician
  • Yakima, WA
National Provider Identifier
1306905138
Registry record updated May 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
0021581 Issued in WA
Legal business name
J. HAMILTON LICHT, M.D., P.C.
Doing business as
Nephrology Associates of Yakima
Practice address
315 Holton Ave
Suite 100
Yakima, WA 98902-3254
Phone
(509) 248-6292
Fax
(509) 248-9134
NPI assigned
Dec 7, 2006
Last updated
May 1, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2019

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

Authorized official

Name
J. Hamilton Licht, M.D.
Title
President
Phone
(509) 248-6292

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 0021581 WA Primary

Addresses

Primary practice location

315 Holton Ave
Suite 100
Yakima, WA 98902-3254

Mailing address

315 Holton Ave
Suite 100
Yakima, WA 98902-3254
Phone (509) 248-6292

Other identifiers 2

IdentifierTypeStateIssuer
1301506MedicaidWA
DE5146OtherRAILROAD MEDICARE

Other names 1

  • Nephrology Associates of Yakima Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050902000669 WA Part B Supplier - Clinic/Group Practice 0648202242 Receives reassigned benefits from 5 practitioners
Practice locations: Yakima, WA

National Provider Directory

National Provider Directory

Locations

1111 W Yakima Ave
Yakima, WA 98902
Phone (509) 452-1403

315 Holton Ave
Ste 100
Yakima, WA 98902
Phone (509) 248-6292

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1165449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556668800000",
    "number": "1306905138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 HOLTON AVE",
            "address_2": "SUITE 100",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023254",
            "telephone_number": "509-248-6292",
            "fax_number": "509-248-9134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 HOLTON AVE",
            "address_2": "SUITE 100",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023254",
            "telephone_number": "509-248-6292",
            "fax_number": "509-248-9134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. HAMILTON LICHT, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-07",
        "last_updated": "2019-05-01",
        "status": "A",
        "authorized_official_last_name": "LICHT",
        "authorized_official_first_name": "J. HAMILTON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "509-248-6292",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "WA",
            "license": "0021581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1301506",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE5146",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nephrology Associates of Yakima",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Nephrology Associates of Yakima",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2019; 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.