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Optum Care Washington PLLC

Organization Active NPI Ambulatory Surgical Clinic/Center · Edmonds, WA

NPI 1467907287 · NPPES record last updated Apr 9, 2024

Key facts

NPI
1467907287
Entity type
Organization (NPI type 2)
Primary specialty
Ambulatory Surgical Clinic/Center 261QA1903X
Legal business name
OPTUM CARE WASHINGTON PLLC
Practice address
21401 72ND Ave W
Edmonds, WA 98026-7702
Phone
(425) 258-3900
NPI assigned
Aug 22, 2016
Organization subpart
Yes
Parent organization (as reported)
EVERETT PHYSICIANS, INC. P.S.

Authorized official

Name
George Go
Title
Board President
Phone
(425) 258-3900

Other NPIs with the same Medicare PAC ID 19

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 29

Organizations that report the same tax identification number in the National Provider Directory.

View all 29

Practitioners 684

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 684

Medicare Care Compare: Ambulatory surgical center

Listed as
The Everett Clinic CCN 50C0001327
Medicare certification status
Active (Provider of Services file)

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in WA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20161202001290 WA Part B Supplier - Ambulatory Surgical Center 6406752153 Practice locations: Edmonds, WA
O20161220002299 WA DME Supplier - Ambulatory Surgical Center
DME Supplier - Orthotic Personnel		 6406752153 Practice locations: Edmonds, WA

National Provider Directory

Tax ID family
Everett Clinic (30 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Yes
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

21401 72ND Ave W
Edmonds, WA 98026-7702

Mailing address

PO Box 5127
Everett, WA 98206-5127
Phone (425) 258-3900

Other names

  • The Edmonds Surgery Center Doing business as

Other providers in Edmonds, WA

All providers in Edmonds, WA · Ambulatory Surgical Clinic/Center in Washington

Sources for this page

Verify at the official NPI Registry.