NPIMap

Individual provider Active NPI

Edward Elias Katime, MD

  • Family Medicine Physician
  • Port Angeles, WA
National Provider Identifier
1386968824
Registry record updated Apr 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD61144347 Issued in WA
Practice address
907 Georgiana St
Port Angeles, WA 98362-3911
Phone
(360) 565-0999
NPI assigned
Mar 25, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A119474 CA
Hospitalist Physician 208M00000X A119474 CA
Hospitalist Physician 208M00000X 290235 NY
Family Medicine Physician 207Q00000X MD61144347 WA Primary

Addresses

Primary practice location

907 Georgiana St
Port Angeles, WA 98362-3911

Mailing address

PO Box 850
Port Angeles, WA 98362-0146
Phone (360) 565-0999

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
I20210408002217 WA Practitioner - Family Practice 2365665742 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Olympic Medical PhysiciansGroup PAC ID 9537172358, 106 clinicians

Practice addresses (Care Compare)

907 Georgiana St
Port Angeles, WA 98362-3911
Phone (360) 565-0999

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.56 of 100Reported as group
Quality
80.73
Promoting interoperability
80
Improvement activities
40
Cost
74.47

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 Medicine

State licenses

LicenseStateTypeSpecialty
A119474CAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Olympic Medical Physicians Family Medicine CurrentSince Apr 5, 2021 Accepting new patients
Stony Brook Internists, University Faculty Practice Corporation Past Accepting new patients

Locations

433 E 8th St
Port Angeles, WA 98362
Phone (360) 452-3373

907 Georgiana St
Port Angeles, WA 98362
Phone (360) 565-0550

Interoperability endpoints

  • Direct secure messaging: ekatime1659080@wm.providencedirect.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1269475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617235200000",
    "number": "1386968824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983620146",
            "telephone_number": "360-565-0999",
            "fax_number": "360-565-0901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 GEORGIANA ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983623911",
            "telephone_number": "360-565-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATIME",
        "first_name": "EDWARD",
        "middle_name": "ELIAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-25",
        "last_updated": "2021-04-01",
        "certification_date": "2021-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A119474",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A119474",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "290235",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61144347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Angeles, WA

Sources for this page

Verify at the official NPI Registry.