Justin Charles Cooper, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA60640498 Issued in WA

Practice address

1800 Cooks Hill Rd
Suite F
Centralia, WA 98531-9072

Phone

(360) 827-6700

NPI assigned

Feb 26, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St Vincent HospitalGroup PAC ID 6608775135, 335 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christus St Vincent Regional Medical Center Hospital, Santa Fe, NM, CCN 320002
• Presbyterian Santa Fe Medical Center Hospital, Santa Fe, NM, CCN 320090
• Los Alamos Medical Center Hospital, Los Alamos, NM, CCN 320033

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jcooper383926@christushealth.direct-ci.net

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.

• St Vincent Hospital

  • Pediatrics Physician
  • Santa Fe, NM
  • NPI 1063367803
  Medicare reassignment Care Compare group
• St Vincent Hospital

  • Neurology Physician
  • Santa Fe, NM
  • NPI 1477190882
  NPD
• St Vincent Hospital

  • General Acute Care Hospital
  • Santa Fe, NM
  • NPI 1578587150
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• PHC-Los Alamos Inc

  • Rural Acute Care Hospital
  • Los Alamos, NM
  • NPI 1285701623
  Care Compare affiliation
• Presbyterian Healthcare Services

  • General Acute Care Hospital
  • Santa Fe, NM
  • NPI 1730684853
  Care Compare affiliation
• St Vincent Hospital

  • General Acute Care Hospital
  • Santa Fe, NM
  • NPI 1578587150
  Care Compare affiliation

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

{
    "created_epoch": "1424908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487721600000",
    "number": "1316339385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 COOKS HILL RD",
            "address_2": "SUITE F",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985319072",
            "telephone_number": "360-827-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "JUSTIN",
        "middle_name": "CHARLES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-26",
        "last_updated": "2017-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60640498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Terese Cook
• Kaylee Jean Cook, MSOT
• Cynthia Ann Cooke, M.S.P.T.
• Tammera M Cooke, MA, LMHC, PSYD
• Kenneth J Coombs, PT
• Loren D Cooper, M.D.
• Emily Corcoran
• Cornerstone Center for Development PLLC
• Debra Lynne Cornwell
• Cassie D Cosser

• Physician Assistant in Centralia, WA
• Providers in Centralia, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.