NPIMap

Individual provider Active NPI

Marshall Edward McCabe IV, D.O.

  • Gastroenterology Physician
  • Olympia, WA
National Provider Identifier
1447514302
Registry record updated Sep 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
OP60945227 Issued in WA
Practice address
406 Black Hills LN SW Ste a
Olympia, WA 98502
Phone
(360) 754-1735
NPI assigned
Jun 26, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 02004673A IN
Student in an Organized Health Care Education/Training Program 390200000X 11016698A IN
Gastroenterology Physician 207RG0100X OP60945227 WA Primary

Addresses

Primary practice location

406 Black Hills LN SW Ste a
Olympia, WA 98502

Mailing address

406 Black Hills LN SW Ste a
Olympia, WA 98502-8144
Phone (360) 754-1735

Other practice location 1

1120 South Dr., Fesler Hall; 224
Indianapolis, IN 46202
Phone (317) 656-4260

Other identifiers 1

IdentifierTypeStateIssuer
201121960MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190617002369 WA Practitioner - GastroenterologyPractitioner - Internal Medicine 0446499826 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Arizona College of Osteopathic Medicine Mid Western University, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Olympia Multi Specialty ClinicGroup PAC ID 4789571092, 21 clinicians

Practice addresses (Care Compare)

406 Black Hills LN SW
Suite a
Olympia, WA 98502-8144
Phone (360) 754-1727

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy112
Upper gastrointestinal (GI) endoscopy for acid reflux165

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Olympia Multi Specialty Clinic CurrentSince Aug 1, 2019 Accepting new patients

Locations

406 Black Hills Ln SW
Ste A
Olympia, WA 98502
Phone (360) 754-1727

Organizations & group practices 1

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 9

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": "1340668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567468800000",
    "number": "1447514302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 BLACK HILLS LN SW STE A",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028144",
            "telephone_number": "360-754-1735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 BLACK HILLS LN SW STE A",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "98502",
            "telephone_number": "360-754-1735"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1120 South Dr., Fesler Hall; 224",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "46202",
            "country_code": "US",
            "telephone_number": "317-656-4260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCABE",
        "first_name": "MARSHALL",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-26",
        "last_updated": "2019-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "02004673A",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "11016698A",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WA",
            "license": "OP60945227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201121960",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.