Individual provider Active NPI

Morgan Weant Sanders, PAC

  • Physician Assistant
  • Everett, WA
National Provider Identifier
1417370586
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60481562 Issued in WA
Practice address
12800 Bothell Everett Hwy
Everett, WA 98208-6642
Phone
(425) 316-5150
NPI assigned
Jan 27, 2014
Last updated
Mar 31, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110-004484 VA
Physician Assistant 363A00000X PA60481562 WA Primary

Addresses

Primary practice location

12800 Bothell Everett Hwy
Everett, WA 98208-6642

Mailing address

PO Box 3360
Portland, OR 97208-3360
Phone (866) 366-2983

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address msanders488134@wm.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150116001811 WA Practitioner - Physician Assistant 0648499202 Reassigns benefits to 1 organization
I20170726001582 FL Practitioner - Physician Assistant 0648499202 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Solantic of Jacksonville LLCGroup PAC ID 1052409307, 56 clinicians

Practice addresses (Care Compare)

1021 Cesery Blvd
Jacksonville, FL 32211-5609
Phone (615) 600-4074

151 Pine Lake Dr
Suite B
Ponte Vedra, FL 32081-5182
Phone (904) 543-3677

1708 Blanding Blvd
Middleburg, FL 32068-3836
Phone (615) 600-4074

2401 Monument Rd
Jacksonville, FL 32225-2520
Phone (904) 642-0337

410 Atlantic Blvd
Neptune Beach, FL 32266-4022
Phone (615) 600-4074

4498 Hendricks Ave
Jacksonville, FL 32207-6326
Phone (615) 600-4074

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0110-004484VAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services- Washington CurrentSince Jan 1, 2015 Accepting new patients
Providence Health & Services- Washington CurrentSince Jan 1, 2015 Accepting new patients
Solantic of Jacksonville, LLC PastSince Sep 5, 2021 Accepting new patients

Locations

12800 Bothell Everett Hwy
Everett, WA 98208
Phone (425) 316-5060

1321 Colby Ave
Ofc
Everett, WA 98201
Phone (425) 261-4076

4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330

Interoperability endpoints

  • Direct secure messaging: msanders488134@wm.providencedirect.org

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1390780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1417370586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360",
            "telephone_number": "866-366-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12800 BOTHELL EVERETT HWY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982086642",
            "telephone_number": "425-316-5150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "MORGAN",
        "middle_name": "WEANT",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-27",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110-004484",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60481562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msanders488134@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "12800 Bothell Everett Hwy",
            "city": "Everett",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982086642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.