Active NPI
Stanley M Sugarman, MD
- Internal Medicine Physician
- Vancouver, WA
National Provider Identifier
1497791230
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD00023640
- Practice address
- 222 NE Park Plaza Dr
Suite 100
Vancouver, WA 98684-5899 - Phone
- (360) 254-8025
- Fax
- (360) 254-8618
- NPI assigned
- Jun 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 23640 | WA | |
| Internal Medicine Physician | 207R00000X | MD00023640 | WA | Primary |
Addresses
Primary practice location
222 NE Park Plaza Dr
Suite 100
Vancouver, WA 98684-5899
Mailing address
222 NE Park Plaza Dr
Suite 100
Vancouver, WA 98684-5899
Phone (360) 254-8025
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013796 | Medicaid | WA | |
| 110047161 | Other | WA | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23640 | WA | MD | Specialist |
| MD00023640 | WA | MD | Internal Medicine Physician |
Interoperability endpoints
- admin@nwmedical.e-mdsdirect.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216339200000",
"number": "1497791230",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 NE PARK PLAZA DR",
"address_2": "SUITE 100",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986845899",
"telephone_number": "360-254-8025",
"fax_number": "360-254-8618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 NE PARK PLAZA DR",
"address_2": "SUITE 100",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986845899",
"telephone_number": "360-254-8025",
"fax_number": "360-254-8618"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUGARMAN",
"first_name": "STANLEY",
"middle_name": "M",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-21",
"last_updated": "2008-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "WA",
"license": "23640",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WA",
"license": "MD00023640",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1013796",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "110047161",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.