Individual provider Active NPI

Michael T Ontkean, DO

  • Cardiovascular Disease Physician
  • Vancouver, WA
National Provider Identifier
1336198563
Registry record updated Nov 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
OP00001374 Issued in WA
Practice address
200 NE Mother Joseph PL
Suite 200
Vancouver, WA 98664-3299
Phone
(360) 256-2640
Fax
(360) 260-7288
NPI assigned
May 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X OP00001374 WA Primary
Interventional Cardiology Physician 207RI0011X OP00001374 WA

Addresses

Primary practice location

200 NE Mother Joseph PL
Suite 200
Vancouver, WA 98664-3299

Mailing address

200 NE Mother Joseph PL
Suite 400
Vancouver, WA 98664-3299
Phone (360) 514-4444

Other identifiers 1

IdentifierTypeStateIssuer
8109654MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cascade Heart PS Cardiovascular Disease PastSince Mar 2, 2004 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: montkean56049@direct.peacehealth.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1146873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448236800000",
    "number": "1336198563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 NE MOTHER JOSEPH PL",
            "address_2": "SUITE 400",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643299",
            "telephone_number": "360-514-4444",
            "fax_number": "360-514-6530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 NE MOTHER JOSEPH PL",
            "address_2": "SUITE 200",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643299",
            "telephone_number": "360-256-2640",
            "fax_number": "360-260-7288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONTKEAN",
        "first_name": "MICHAEL",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-06",
        "last_updated": "2015-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WA",
            "license": "OP00001374",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "WA",
            "license": "OP00001374",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8109654",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Nov 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.