Individual provider Active NPI

Sydnii Mari Ray, PAC

  • Medical Physician Assistant
  • Bellingham, WA
National Provider Identifier
1417513383
Registry record updated Feb 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA61377687 Issued in WA
Practice address
3130 Squalicum Pkwy
Bellingham, WA 98225-1940
Phone
(360) 671-4509
Fax
(360) 756-5184
NPI assigned
May 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA2187 NV
Medical Physician Assistant 363AM0700X PA61377687 WA Primary
Surgical Physician Assistant 363AS0400X NV

Addresses

Primary practice location

3130 Squalicum Pkwy
Bellingham, WA 98225-1940

Mailing address

3130 Squalicum Pkwy
Bellingham, WA 98225-1940
Phone (360) 671-4509

Other identifiers 1

IdentifierTypeStateIssuer
PA61377687OtherWASTATE LICENSE NUMBER

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230309001231 WA Practitioner - Physician Assistant 0648600403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Loma Linda University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Care Network, PLLCGroup PAC ID 0446142046, 124 clinicians

Practice addresses (Care Compare)

1610 Grover St
Lynden, WA 98264-1539

205 W Stewart Rd
Suite 104
Mount Vernon, WA 98273-9607
Phone (360) 395-2938

3130 Squalicum Pkwy
Bellingham, WA 98225-1940

715 W Orchard Dr
Suite 4
Bellingham, WA 98225-1767
Phone (360) 746-3850

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA61377687WAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Network PLLC CurrentSince Apr 1, 2023 Accepting new patients
Family Care Network PLLC CurrentSince Apr 1, 2023 Accepting new patients
Family Care Network PLLC Past Accepting new patients

Locations

3130 Squalicum Pkwy
Bellingham, WA 98225
Phone (360) 671-4509

3130 Squalicum Pkwy
Ste 100
Bellingham, WA 98225
Phone (360) 671-4509

1610 Grover St
Ste D1
Lynden, WA 98264
Phone (360) 312-3785

Interoperability endpoints

  • Direct secure messaging: sray20206@direct.fcn.net

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1557878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677542400000",
    "number": "1417513383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3130 SQUALICUM PKWY",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251940",
            "telephone_number": "360-671-4509",
            "fax_number": "360-756-5184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 SQUALICUM PKWY",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251940",
            "telephone_number": "360-671-4509",
            "fax_number": "360-756-5184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "SYDNII",
        "middle_name": "MARI",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-15",
        "last_updated": "2023-02-28",
        "certification_date": "2023-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NV",
            "license": "PA2187",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA61377687",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NV",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "PA61377687",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

Verify at the official NPI Registry.