Individual provider Active NPI

Sydney T. De Cejka, PA

  • Physician Assistant
  • Kennewick, WA
National Provider Identifier
1467910265
Registry record updated Dec 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60943884 Issued in WA
Practice address
4804 W Clearwater Ave
Kennewick, WA 99336-2119
Phone
(509) 942-2355
Fax
(509) 222-1289
NPI assigned
Mar 11, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA60943884 WA Primary
Physician Assistant 363A00000X

Addresses

Primary practice location

4804 W Clearwater Ave
Kennewick, WA 99336-2119

Mailing address

4804 W Clearwater Ave
Kennewick, WA 99336-2119
Phone (509) 942-2355

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190606002925 WA Practitioner - Physician Assistant 5092048041 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kadlec Regional Medical CenterGroup PAC ID 9739098617, 402 clinicians

Practice addresses (Care Compare)

1135 Jadwin Ave
Richland, WA 99352-3434
Phone (509) 942-3300

Hospital & facility affiliations

  • Kadlec Regional Medical Center Hospital, Richland, WA, CCN 500058

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA60943884WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kadlec Regional Medical Center CurrentSince Nov 1, 2021 Accepting new patients
Kadlec Regional Medical Center CurrentSince Nov 1, 2021 Accepting new patients

Locations

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

1135 Jadwin Ave
Richland, WA 99352
Phone (509) 942-3300

550 Gage Blvd
Ste 101
Richland, WA 99352

Organizations & group practices 4

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 1

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": "1552262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1467910265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4804 W CLEARWATER AVE",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993362119",
            "telephone_number": "509-942-2355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4804 W CLEARWATER AVE",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993362119",
            "telephone_number": "509-942-2355",
            "fax_number": "509-222-1289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE CEJKA",
        "first_name": "SYDNEY",
        "middle_name": "T.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-11",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60943884",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

Verify at the official NPI Registry.