Active NPI
Franciscan Medical Group
Doing business as FMG-Kitsap Urology Associates
- Urology Physician
- Port Orchard, WA
National Provider Identifier
1396063525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- Legal business name
- FRANCISCAN MEDICAL GROUP
- Doing business as
- FMG-Kitsap Urology Associates
- Practice address
- 451 SW Sedgwick Rd
Ste 220
Port Orchard, WA 98367-6425 - Phone
- (360) 874-7300
- Fax
- (360) 874-7319
- NPI assigned
- May 12, 2010
- Last updated
- May 12, 2010
- Organization subpart
- Yes
- Parent organization
- FRANCISCAN MEDICAL GROUP
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dean A. Field, MD
- Title
- President and Chief Medical Officer
- Phone
- (253) 779-4009
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | WA | Primary |
Addresses
Primary practice location
451 SW Sedgwick Rd
Ste 220
Port Orchard, WA 98367-6425
Mailing address
451 SW Sedgwick Rd
Ste 220
Port Orchard, WA 98367-6425
Phone (360) 874-7300
Other names 1
- FMG-Kitsap Urology Associates
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031111000789 | WA | Part B Supplier - Clinic/Group Practice | 0547173866 |
Receives reassigned benefits from 1,720 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
National Provider Directory- Part of
- CHI Franciscan Health
Locations
451 SW Sedgwick Rd
Ste 220
Port Orchard, WA 98367
Phone (360) 874-7300
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273622400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1273622400000",
"number": "1396063525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "451 SW SEDGWICK RD",
"address_2": "STE 220",
"city": "PORT ORCHARD",
"state": "WA",
"postal_code": "983676425",
"telephone_number": "360-874-7300",
"fax_number": "360-874-7319"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "451 SW SEDGWICK RD",
"address_2": "STE 220",
"city": "PORT ORCHARD",
"state": "WA",
"postal_code": "983676425",
"telephone_number": "360-874-7300",
"fax_number": "360-874-7319"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FRANCISCAN MEDICAL GROUP",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "FRANCISCAN MEDICAL GROUP",
"enumeration_date": "2010-05-12",
"last_updated": "2010-05-12",
"status": "A",
"authorized_official_last_name": "FIELD",
"authorized_official_first_name": "DEAN",
"authorized_official_middle_name": "A.",
"authorized_official_title_or_position": "PRESIDENT AND CHIEF MEDICAL OFFICER",
"authorized_official_telephone_number": "253-779-4009",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "WA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "FMG-Kitsap Urology Associates",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Port Orchard, WA
- Joella Elizabeth Folk Pettigrew, D.C., LM
- Stephanie S Forsberg, L.M.P.
- Jeanne Kaye Forshaw, LMP
- Fiaer Foster, BSCHONS
- Found Therapy Services, PLLC
- Franciscan Medical Group (Port Orchard Medical Clinic)
- Franciscan Medical Group (Franciscan Medical Clinic - Port Orchard)
- Frandsen Family Medicine PS (Sound Health Care Center)
- Brad R Frandsen, MD
- Karleen Rae Franklin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.