Individual provider Active NPI

Angelica Orozco Kominsky, ARNP

  • Nurse Practitioner
  • Mount Vernon, WA
National Provider Identifier
1427696236
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP61030661 Issued in WA
Practice address
307 S 13TH St Ste 300
Mount Vernon, WA 98274-4100
Phone
(360) 336-9757
Fax
(360) 814-5237
NPI assigned
Dec 12, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Nurse Practitioner 363L00000X AP61030661 WA Primary

Addresses

Primary practice location

307 S 13TH St Ste 300
Mount Vernon, WA 98274-4100

Mailing address

1400 E Kincaid St
Mount Vernon, WA 98274-4127

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
I20200921000972 WA Practitioner - Nurse Practitioner 3375961535 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

2214 E 29TH Ave
Spokane, WA 99203-3939
Phone (509) 755-5250

311 S L St
Tacoma, WA 98405-3720

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital Dist No 1 Skagit Current Accepting new patients
Molina Healthcare of Washington, Inc CurrentSince Sep 14, 2020 Accepting new patients
Multicare Health System Current Accepting new patients
Multicare Health System CurrentSince Jan 1, 2025 Accepting new patients
Molina Healthcare of Washington, Inc Current Accepting new patients
Multicare Health System Nurse Practitioner CurrentSince Jan 1, 2025 Accepting new patients
Public Hospital Dist No 1 Skagit CurrentSince Mar 1, 2021 Accepting new patients
Multicare Health System Nurse Practitioner Past Accepting new patients

Locations

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

2511 M Ave
Ste D
Anacortes, WA 98221
Phone (360) 293-0308

15 SW Everett Mall Way
Ste A
Everett, WA 98204
Phone (425) 348-6727

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

1400 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 428-2586

307 S 13th St
Ste 300
Mount Vernon, WA 98274
Phone (360) 336-9757

2214 E 29th Ave
Spokane, WA 99203
Phone (509) 755-5250

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Interoperability endpoints

  • Direct secure messaging: akominsky25835@skagit.direct-ci.com
  • Direct secure messaging: akominsky389297@direct.peacehealth.org

Organizations & group practices 8

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 1

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": "1576108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1427696236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E KINCAID ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 S 13TH ST STE 300",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744100",
            "telephone_number": "360-336-9757",
            "fax_number": "360-814-5237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMINSKY",
        "first_name": "ANGELICA",
        "middle_name": "OROZCO",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-12",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61030661",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

Verify at the official NPI Registry.