NPIMap

Individual provider Active NPI

Michael Lawrence Chernekoff, PA-C

  • Physician Assistant
  • Bremerton, WA
National Provider Identifier
1356429716
Registry record updated Jan 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10003909 Issued in WA
Practice address
1225 Campbell Way
Suite 201
Bremerton, WA 98310-3351
Phone
(360) 377-1355
Fax
(360) 377-1558
NPI assigned
Nov 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10003909 WA Primary

Addresses

Primary practice location

1225 Campbell Way
Suite 201
Bremerton, WA 98310-3351

Mailing address

2520 Cherry Ave
Bremerton, WA 98310-4229
Phone (360) 377-3911

Other identifiers 2

IdentifierTypeStateIssuer
253470OtherINTERNAL ID-MOTOR VEHICLE ID
8320624MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070326000463 WA Practitioner - Physician Assistant 6800990193 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
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)

1800 NW Myhre Rd
Silverdale, WA 98383-7663
Phone (564) 240-1000

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

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince Jul 2, 2017 Accepting new patients
Franciscan Medical Group CurrentSince Jul 2, 2017 Accepting new patients
Franciscan Medical Group Physician Assistant Past Accepting new patients
Harrison Medical Center Past Accepting new patients

Locations

1225 Campbell Way
Ste 201
Bremerton, WA 98310
Phone (360) 377-1355

2520 Cherry Ave
Bremerton, WA 98310
Phone (360) 377-3911

9633 Levin Rd NW
Ste 103
Silverdale, WA 98383
Phone (360) 337-8200

1950 NW Myhre Rd
Fl 3
Silverdale, WA 98383
Phone (564) 240-4200

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

Interoperability endpoints

  • Direct secure messaging: mchernekoff58729@fhsce.catholichealth.net

Organizations & group practices 4

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 5

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451865600000",
    "number": "1356429716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 CHERRY AVE",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983104229",
            "telephone_number": "360-377-3911",
            "fax_number": "360-377-1558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 CAMPBELL WAY",
            "address_2": "SUITE 201",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983103351",
            "telephone_number": "360-377-1355",
            "fax_number": "360-377-1558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERNEKOFF",
        "first_name": "MICHAEL",
        "middle_name": "LAWRENCE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2016-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10003909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERNAL ID-MOTOR VEHICLE ID",
            "identifier": "253470",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8320624",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

Verify at the official NPI Registry.