NPIMap

Organization Active NPI

Optum Care Washington PLLC

  • Ambulatory Surgical Clinic/Center
  • Arlington, WA
National Provider Identifier
1366154304
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
OPTUM CARE WASHINGTON PLLC
Practice address
4011 172ND St NE
Arlington, WA 98223
Phone
(360) 454-1900
NPI assigned
Dec 21, 2022
Last updated
Apr 9, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
EVERETT PHYSICIANS, INC. P.S.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Authorized official

Name
George Go, M.D.
Title
Board President
Phone
(425) 259-0966

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X NU Primary
Durable Medical Equipment & Medical Supplies 332B00000X NU

Addresses

Primary practice location

4011 172ND St NE
Arlington, WA 98223

Mailing address

PO Box 5127
Everett, WA 98206-5127
Phone (425) 339-5408

Other names 1

  • Optum - Helen Holm Pumphrey Surgery Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20031211000922 WA Part B Supplier - Clinic/Group Practice 6406752153 Receives reassigned benefits from 1,384 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Everett, WA; Mill Creek, WA; Kirkland, WA; La Conner, WA; Lake Stevens, WA; Lynnwood, WA; Marysville, WA; Mountlake Terrace, WA…
O20231127002078 WA Part B Supplier - Ambulatory Surgical Center 6406752153 Practice locations: Arlington, WA
O20240328003828 WA DME Supplier - Ambulatory Surgical Center 6406752153 Practice locations: Arlington, WA

Other NPIs with the same Medicare PAC ID 19

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 19

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
The Everett Clinic PLLC Dba Helen Holm Pumphrey Surgery CenterCCN 50C0001345
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

9924 NE 185th St
Ste 215
Bothell, WA 98011
Phone (425) 595-3830

900 Pacific Ave
Everett, WA 98201
Phone (425) 258-7900

4420 76th St NE
Marysville, WA 98270
Phone (360) 651-7490

Practitioners & affiliated clinicians

Practitioners 217

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 217

NPI Registry JSON

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

{
    "created_epoch": "1671580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712620800000",
    "number": "1366154304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5127",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982065127",
            "telephone_number": "425-339-5408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 172ND ST NE",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "98223",
            "telephone_number": "360-454-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTUM CARE WASHINGTON PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EVERETT PHYSICIANS, INC. P.S.",
        "enumeration_date": "2022-12-21",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A",
        "authorized_official_last_name": "GO",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "BOARD PRESIDENT",
        "authorized_official_telephone_number": "425-259-0966",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optum - Helen Holm Pumphrey Surgery Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Arlington, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.