Individual provider Active NPI

Yury Filitovich, PA-C

  • Physician Assistant
  • Everett, WA
National Provider Identifier
1487990362
Registry record updated Jun 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60317900 Issued in WA
Practice address
3726 Broadway Ste 201
Everett, WA 98201-3788
Phone
(425) 317-9119
Fax
(425) 317-9118
NPI assigned
Dec 20, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA60317900 WA
Physician Assistant 363A00000X PA60317900 WA Primary

Addresses

Primary practice location

3726 Broadway Ste 201
Everett, WA 98201-3788

Mailing address

3726 Broadway Ste 201
Everett, WA 98201-3788
Phone (425) 317-9119

Other identifiers 1

IdentifierTypeStateIssuer
2024579MedicaidWA

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
I20130225000353 WA Practitioner - Physician Assistant 6406001460 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Washington Medical Group Inc PSGroup PAC ID 7517870314, 111 clinicians

Practice addresses (Care Compare)

1321 Colby Ave
Everett, WA 98201-1665
Phone (425) 261-2000

1700 13TH St
Everett, WA 98201-1689
Phone (425) 252-0895

3726 Broadway
Everett, WA 98201-3788

Hospital & facility affiliations

  • Providence Regional Medical Center Everett Hospital, Everett, WA, CCN 500014

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA60317900WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Care Washington PLLC CurrentSince May 4, 2015 Accepting new patients
Western Washington Medical Group, Inc PS CurrentSince Jul 6, 2020 Accepting new patients
Optum Care Washington PLLC CurrentSince May 4, 2015 Accepting new patients
Providence Health & Services- Washington CurrentSince Aug 27, 2018 Accepting new patients
Providence Health & Services - Washington CurrentSince Aug 27, 2018 Accepting new patients
Western Washington Medical Group, Inc PS CurrentSince Jul 6, 2020 Accepting new patients
Western Washington Medical Group, Inc PS Past Accepting new patients

Locations

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

1717 13th St
Ste 401
Everett, WA 98201
Phone (425) 261-4910

1728 W Marine View Dr
Ste 111
Everett, WA 98201

3726 Broadway
Ste 201
Everett, WA 98201
Phone (425) 317-9119

4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

Interoperability endpoints

  • Direct secure messaging: yfilitovich726871@direct.multicare.org

Organizations & group practices 8

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": "1355961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593043200000",
    "number": "1487990362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3726 BROADWAY STE 201",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013788",
            "telephone_number": "425-317-9119",
            "fax_number": "425-317-9118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3726 BROADWAY STE 201",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013788",
            "telephone_number": "425-317-9119",
            "fax_number": "425-317-9118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FILITOVICH",
        "first_name": "YURY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-20",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA60317900",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60317900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2024579",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.