NPIMap

Individual provider Active NPI

Zachary Michael Kane, D.O.

  • Internal Medicine Physician
  • Poulsbo, WA
National Provider Identifier
1366852105
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OP60754977 Issued in WA
Practice address
22180 Olympic College Way NW Ste 102
Poulsbo, WA 98370-6664
Phone
(360) 779-4444
Fax
(360) 377-1558
NPI assigned
May 2, 2014
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OP60754977 WA Primary

Addresses

Primary practice location

22180 Olympic College Way NW Ste 102
Poulsbo, WA 98370-6664

Mailing address

22180 Olympic College Way NW Ste 102
Poulsbo, WA 98370-6664
Phone (360) 779-4444

Other identifiers 1

IdentifierTypeStateIssuer
2037963MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address zkane61290@fhsce.catholichealth.net Direct

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
I20170627003331 WA Practitioner - Internal MedicinePractitioner - Hospitalist 8426277294 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

22180 Olympic College Way NW
Suite 102
Poulsbo, WA 98370-6664
Phone (360) 779-4444

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Sound Inpatient Physicians PLLC Internal Medicine CurrentSince Jun 1, 2017 Accepting new patients
Franciscan Medical Group CurrentSince Mar 4, 2019 Accepting new patients
Franciscan Medical Group Internal Medicine CurrentSince Mar 4, 2019 Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine CurrentSince Jun 1, 2017 Accepting new patients

Locations

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

22180 Olympic College Way NW
Ste 102
Poulsbo, WA 98370
Phone (360) 779-4444

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

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

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 11

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": "1398988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1366852105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22180 OLYMPIC COLLEGE WAY NW STE 102",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983706664",
            "telephone_number": "360-779-4444",
            "fax_number": "360-377-1558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22180 OLYMPIC COLLEGE WAY NW STE 102",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983706664",
            "telephone_number": "360-779-4444",
            "fax_number": "360-377-1558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANE",
        "first_name": "ZACHARY",
        "middle_name": "MICHAEL",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-02",
        "last_updated": "2022-07-21",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "OP60754977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2037963",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "zkane61290@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "22180 Olympic College Way NW Ste 102",
            "city": "Poulsbo",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983706664",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Poulsbo, WA

Sources for this page

Verify at the official NPI Registry.