NPIMap

Individual provider Active NPI

Dean Short, PA-C

  • Physician Assistant
  • Port Townsend, WA
National Provider Identifier
1356455745
Registry record updated Mar 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10005046 Issued in WA
Practice address
834 Sheridan St
Port Townsend, WA 98368-2443
Phone
(360) 344-3090
Fax
(360) 344-3089
NPI assigned
Aug 19, 2006
Last updated
Mar 15, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2019

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 PA10005046 WA Primary

Addresses

Primary practice location

834 Sheridan St
Port Townsend, WA 98368-2443

Mailing address

808 N 5TH Ave
Sequim, WA 98382-3045
Phone (360) 683-5900

Other identifiers 2

IdentifierTypeStateIssuer
P00406337OtherRAILROAD MEDICARE
8462178MedicaidWA

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
I20061020000073 WA Practitioner - Physician Assistant 6002801370 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
Jamestown S'Klallam TribeGroup PAC ID 2365349495, 38 clinicians

Practice addresses (Care Compare)

526 S 9TH Ave
Sequim, WA 98382-3626
Phone (360) 683-5900

808 N 5TH Ave
Sequim, WA 98382-3045
Phone (360) 683-5900

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA10005046WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Jamestown S'Klallam Tribe CurrentSince Oct 1, 2018 Accepting new patients
John a Yezerski, MD Past Accepting new patients
Center for Bone & Joint Surgery LTD PastSince Aug 4, 1999 Accepting new patients
North Columbus Spine, PC Past Accepting new patients

Locations

526 S 9th Ave
Sequim, WA 98382
Phone (360) 681-7755

808 N 5th Ave
Sequim, WA 98382
Phone (360) 582-4840

Interoperability endpoints

  • Direct secure messaging: dshort281333@wm.providencedirect.org
  • FHIR API: https://api.platform.athenahealth.com/22724/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552608000000",
    "number": "1356455745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 N 5TH AVE",
            "city": "SEQUIM",
            "state": "WA",
            "postal_code": "983823045",
            "telephone_number": "360-683-5900",
            "fax_number": "360-582-4800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "834 SHERIDAN ST",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983682443",
            "telephone_number": "360-344-3090",
            "fax_number": "360-344-3089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHORT",
        "first_name": "DEAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2019-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10005046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00406337",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8462178",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Townsend, WA

Sources for this page

Verify at the official NPI Registry.