Luis Carlos Alcalde, PHYSICIAN ASSISTANT

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA10001584 Issued in WA

Practice address

1515 E Columbia St
Othello, WA 99344-1846

Phone

(509) 488-5256

Fax

(509) 488-5256

NPI assigned

Jan 1, 2006

Last updated

Mar 12, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Columbia Basin Health AssociationGroup PAC ID 4486564309, shared by 10 NPIs, 44 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Columbia Basin Health Association

  dba Eagle Eye Care

  • Federally Qualified Health Center (FQHC)
  • Connell, WA
  • NPI 1528316379
  Medicare reassignment
• Columbia Basin Health Association

  • Federally Qualified Health Center (FQHC)
  • Pasco, WA
  • NPI 1225716947
  NPD
• Columbia Basin Health Association

  dba Connell Pharmacy

  • Pharmacist
  • Connell, WA
  • NPI 1629311436
  NPD
• Columbia Valley Emergency Physicians LLC

  • Emergency Medicine Physician
  • Kennewick, WA
  • NPI 1811946056

  Physician Assistant

  NPD (past)
• Washington Em-I Medical Services PC

  • Emergency Medicine Physician
  • Sunnyside, WA
  • NPI 1639128879

  Physician Assistant

  NPD (past)
• Eddy Emergency Group LLC

  • Emergency Medicine Physician
  • Carlsbad, NM
  • NPI 1568487395

  Medical

  NPD (past)
• Pecos Valley of New Mexico, LLC

  • General Practice Physician
  • Carlsbad, NM
  • NPI 1972569820
  NPD (past)

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

{
    "created_epoch": "1136073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615507200000",
    "number": "1376521229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 E COLUMBIA ST",
            "city": "OTHELLO",
            "state": "WA",
            "postal_code": "993441846",
            "telephone_number": "509-488-5256",
            "fax_number": "509-488-9939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 E COLUMBIA ST",
            "city": "OTHELLO",
            "state": "WA",
            "postal_code": "993441846",
            "telephone_number": "509-488-5256",
            "fax_number": "509-488-5256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALCALDE",
        "first_name": "LUIS",
        "middle_name": "CARLOS",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-01",
        "last_updated": "2021-03-12",
        "certification_date": "2021-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10001584",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1037922",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Azalia Acosta
• Adams County Public Hospital District 3 (Othello Community Hospital)
• Admas County Pulic Hospital No. 3 (Othello Community Hospital)
• Ana K Aguirre Monday, MASSAGE THERAPIST
• Ahmed Al Rawe, DDS
• Mikayla E Alonzo, RDH
• Octavio Alvarez Nunez
• Josue Abraham Alvarez, RDH
• Melissa Alvarez, PA-C, PHARMD
• Natalie Andersen, RDH

• Medical Physician Assistant in Othello, WA
• Providers in Othello, WA by specialty
• Medical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.