James Alfred Fasciano, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD60697846 Issued in WA

Practice address

3901 Hoyt Ave
Everett, WA 98201-4918

Phone

(425) 339-5456

Fax

(425) 303-3091

NPI assigned

Feb 22, 2006

Last updated

Jun 10, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 5

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jamestown S'Klallam TribeGroup PAC ID 2365349495, 38 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Olympic Medical Center Hospital, Port Angeles, WA, CCN 500072

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jfasciano1750980@wm.providencedirect.org

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.

• Jamestown S'Klallam Tribe

  dba Jamestown Family Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Sequim, WA
  • NPI 1134181555

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Jamestown S'Klallam Tribe

  dba Jamestown Family Health

  • Family Medicine Physician
  • Sequim, WA
  • NPI 1528809761
  NPD
• Optum Care Washington PLLC

  • Durable Medical Equipment & Medical Supplies
  • Mill Creek, WA
  • NPI 1164972527

  Family Medicine

  NPD (past)
• Western Sierra Medical Clinic, Inc.

  dba Western Sierra Medical Center

  • Federally Qualified Health Center (FQHC)
  • Grass Valley, CA
  • NPI 1063496396
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Clallam County Public Hospital District 2

  dba Olympic Medical Center

  • General Acute Care Hospital
  • Port Angeles, WA
  • NPI 1306845557
  Care Compare affiliation

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1467427443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5127",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982065127",
            "telephone_number": "425-304-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 HOYT AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014918",
            "telephone_number": "425-339-5456",
            "fax_number": "425-303-3091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3916 148th St SE",
            "address_purpose": "LOCATION",
            "city": "Mill Creek",
            "state": "WA",
            "postal_code": "980124751",
            "country_code": "US",
            "telephone_number": "425-304-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FASCIANO",
        "first_name": "JAMES",
        "middle_name": "ALFRED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60697846",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "12953",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G84986",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004716904",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEVADA STATE LICENSE",
            "identifier": "12953",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2069525",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G849860",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CA STATE LICENSE",
            "identifier": "G84986",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Miguel Angel Farias
• Allison Elizabeth Farley, MSW
• Nancy Lyn Farley, MSN, RND
• Sarah Mages Farley, OTR/L
• Taylor Farrant
• Mutarr Fatty
• Anica Rae Faucett, COTA/L
• Judith Ann Faulhaber
• Mary Faulk
• Haddy None Faye-Cham, RN

• Family Medicine Physician in Everett, WA
• Providers in Everett, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.