Individual provider Active NPI

Stanley M Sugarman, MD

  • Internal Medicine Physician
  • Vancouver, WA
National Provider Identifier
1497791230
Registry record updated Jul 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD00023640 Issued in WA
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

Updated by the provider on Jul 18, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1013796MedicaidWA
110047161OtherWARAILROAD 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

LicenseStateTypeSpecialty
23640WAMDSpecialist
MD00023640WAMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: 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.

Verify at the official NPI Registry.