Individual provider Active NPI

Georgianna Nicole Vasilas, PA-C

  • Physician Assistant
  • Federal Way, WA
National Provider Identifier
1346774106
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60921113 Issued in WA
Practice address
34509 9TH Ave S Ste 204
Federal Way, WA 98003-8708
Phone
(538) 355-5102
Fax
(253) 835-5511
NPI assigned
Apr 18, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 55210 CA
Surgical Physician Assistant 363AS0400X PA60921113 WA
Physician Assistant 363A00000X PA60921113 WA Primary

Addresses

Primary practice location

34509 9TH Ave S Ste 204
Federal Way, WA 98003-8708

Mailing address

34509 9TH Ave S Ste 204
Federal Way, WA 98003-8708
Phone (538) 355-5102

Other identifiers 1

IdentifierTypeStateIssuer
2166472MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gvasilas223149@fhsce.catholichealth.net Direct Franciscan Medical Group

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20190329000429 WA Practitioner - Physician Assistant 6507112760 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

16251 Sylvester Rd SW
Burien, WA 98166-3017
Phone (206) 244-9970

16259 Sylvester Rd SW
Burien, WA 98166-3059

1812 S J St
Suite 120
Tacoma, WA 98405-4965
Phone (253) 428-2200

34503 9TH Ave S
Federal Way, WA 98003-8726

Hospital & facility affiliations

  • Highline Medical Center Hospital, Burien, WA, CCN 500011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
55210CAMDPharmacist
7078AZMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Physician Assistant CurrentSince Sep 14, 2020 Accepting new patients
Franciscan Medical Group CurrentSince Sep 20, 2021 Accepting new patients
Multicare Health System CurrentSince Sep 14, 2020 Accepting new patients
Franciscan Medical Group Physician Assistant Past Accepting new patients
Overlake Medical Clinics, LLC Past Accepting new patients

Locations

16259 Sylvester Rd SW
Ste 401
Burien, WA 98166
Phone (206) 242-8837

34503 9th Ave S
Ste 130
Federal Way, WA 98003
Phone (253) 835-5340

34509 9th Ave S
Ste 204
Federal Way, WA 98003
Phone (253) 835-5510

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

315 S K St
Tacoma, WA 98405
Phone (253) 403-1291

Organizations & group practices 8

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1492473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637539200000",
    "number": "1346774106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34509 9TH AVE S STE 204",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980038708",
            "telephone_number": "538-355-5102",
            "fax_number": "253-835-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34509 9TH AVE S STE 204",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980038708",
            "telephone_number": "538-355-5102",
            "fax_number": "253-835-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASILAS",
        "first_name": "GEORGIANNA",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-18",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "55210",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA60921113",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60921113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2166472",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gvasilas223149@fhsce.catholichealth.net",
            "affiliation": "Y",
            "affiliationName": "Franciscan Medical Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "34509 9th Ave S Ste 204",
            "city": "Federal Way",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980038708",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

Verify at the official NPI Registry.