NPIMap

Organization Active NPI

Proliance Surgeons Inc P S

Doing business as Proliance Skagit Northwest Orthopedic Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Mount Vernon, WA
National Provider Identifier
1437105368
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
601484763 Issued in WA
Legal business name
PROLIANCE SURGEONS INC P S
Doing business as
Proliance Skagit Northwest Orthopedic Surgery Center
Practice address
1401 S Laventure Rd
Mount Vernon, WA 98274-6033
Phone
(360) 424-7041
Fax
(360) 424-2418
NPI assigned
May 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Authorized official

Name
Cori M. Pleasant
Title
Del Cred & Enrollment Manager
Phone
(206) 838-2585

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 601484763 WA Primary

Addresses

Primary practice location

1401 S Laventure Rd
Mount Vernon, WA 98274-6033

Mailing address

1401 S Laventure Rd
Mount Vernon, WA 98274-6033
Phone (360) 424-7041

Other identifiers 2

IdentifierTypeStateIssuer
1044177MedicaidWA
173752OtherWAWA LABOR & INDUSTRIES

Other names 2

  • Proliance Skagit Northwest Orthopedic Surgery Center Doing business as
  • Skagit Northwest Orthopedic ASC at LaVenture (FKA) Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031119000128 WA Part B Supplier - Clinic/Group Practice 8527972900 Receives reassigned benefits from 781 practitioners
This NPI is an additional NPI on the enrollment
O20031208000102 WA Part B Supplier - Ambulatory Surgical Center 8527972900 14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kirkland, WA

Other NPIs on the same Medicare enrollment 14

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 14

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Proliance Surgeons Inc PSCCN 50C0001222
Medicare certification status
Terminated Voluntary: merger or closure, Sep 30, 2025From the Provider of Services file

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726099200000",
    "number": "1437105368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S LAVENTURE RD",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982746033",
            "telephone_number": "360-424-7041",
            "fax_number": "360-424-2418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S LAVENTURE RD",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982746033",
            "telephone_number": "360-424-7041",
            "fax_number": "360-424-2418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROLIANCE SURGEONS INC P S",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A",
        "authorized_official_last_name": "PLEASANT",
        "authorized_official_first_name": "CORI",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "DEL CRED & ENROLLMENT MANAGER",
        "authorized_official_telephone_number": "206-838-2585"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "WA",
            "license": "601484763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1044177",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA LABOR & INDUSTRIES",
            "identifier": "173752",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Proliance Skagit Northwest Orthopedic Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Skagit Northwest Orthopedic ASC at LaVenture (FKA)",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.