Individual provider Active NPI

Nikolay A. Usoltsev, M.D.

  • Anesthesiology Physician
  • Everett, WA
National Provider Identifier
1467665893
Registry record updated Aug 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
53068 Issued in WI
Practice address
1321 Colby Ave
Everett, WA 98201-1665
Phone
(715) 387-5511
NPI assigned
May 8, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 53068 WI Primary
Anesthesiology Physician 207L00000X 60339708 WA

Addresses

Primary practice location

1321 Colby Ave
Everett, WA 98201-1665

Mailing address

10 Commerce Dr
New Rochelle, NY 10801-5253
Phone (425) 404-5352

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130606000140 WA Practitioner - Anesthesiology 8426212895 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Wa Anesthesia Services, PCGroup PAC ID 9335298884, 85 clinicians

Practice addresses (Care Compare)

900 Pacific Ave
Everett, WA 98201-4168
Phone (914) 491-9495

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
74.5 of 100Reported as group
Quality
70
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
53068WIMDAnesthesiology Physician
60339708WAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Wa Anesthesia Services, P.C. Anesthesiology CurrentSince May 1, 2013 Accepting new patients

Locations

900 Pacific Ave
Everett, WA 98201
Phone (425) 258-7900

1321 Colby Ave
Everett, WA 98201
Phone (425) 259-4413

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 2

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": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376956800000",
    "number": "1467665893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 COMMERCE DR",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108015253",
            "telephone_number": "425-404-5352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 COLBY AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011665",
            "telephone_number": "715-387-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "USOLTSEV",
        "first_name": "NIKOLAY",
        "middle_name": "A.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2013-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WI",
            "license": "53068",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "60339708",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.