Organization Active NPI

Stuart Cardon

  • Ambulatory Surgical Clinic/Center
  • Yakima, WA
National Provider Identifier
1376692129
Registry record updated May 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
PO00000565 Issued in WA
Legal business name
STUART CARDON
Practice address
2400 Racquet LN
Yakima, WA 98902-6109
Phone
(509) 225-3668
Fax
(509) 225-3448
NPI assigned
Jan 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2020

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

Authorized official

Name
Carrie Marquez
Title
Billing and Credentialing
Phone
(509) 225-3668

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X PO00000565 WA Primary

Addresses

Primary practice location

2400 Racquet LN
Yakima, WA 98902-6109

Mailing address

2400 Racquet LN
Yakima, WA 98902-6109
Phone (509) 225-3668

Other identifiers 1

IdentifierTypeStateIssuer
7142219MedicaidWA

Other names 2

  • Cascade Foot and Ankle PLLC Doing business as
  • Creekside Surgery Center Doing business as

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Creekside Surgery CenterCCN 50C0001277
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D1096972Creekside Surgery Center2400 Racquet LN, Yakima, WA 98902Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Locations

3919 Creekside Loop
Yakima, WA 98902
Phone (509) 225-1496

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588550400000",
    "number": "1376692129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 RACQUET LN",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989026109",
            "telephone_number": "509-225-3668",
            "fax_number": "509-225-3448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 RACQUET LN",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989026109",
            "telephone_number": "509-225-3668",
            "fax_number": "509-225-3448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STUART CARDON",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2020-05-04",
        "certification_date": "2020-05-04",
        "status": "A",
        "authorized_official_last_name": "MARQUEZ",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_title_or_position": "BILLING AND CREDENTIALING",
        "authorized_official_telephone_number": "509-225-3668"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "WA",
            "license": "PO00000565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7142219",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cascade Foot and Ankle PLLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Creekside Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.