Individual provider Active NPI

Dena R Pruitt, PAC

  • Surgical Physician Assistant
  • Seattle, WA
National Provider Identifier
1497908750
Registry record updated Dec 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA60053140 Issued in WA
Practice address
325 9TH Ave # 359798
Seattle, WA 98104-2420
Phone
(206) 520-5000
NPI assigned
Oct 30, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2021

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 PA60053140 WA
Surgical Physician Assistant 363AS0400X PA60053140 WA Primary

Addresses

Primary practice location

325 9TH Ave # 359798
Seattle, WA 98104-2420

Mailing address

325 9TH Ave # 359798
Seattle, WA 98104-2420

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
I20090203000683 WA Practitioner - Physician Assistant 5698839702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Association of University PhysiciansGroup PAC ID 0446162697, 3,484 clinicians

Practice addresses (Care Compare)

325 9TH Ave
Seattle, WA 98104-2420
Phone (206) 731-3000

908 Jefferson St
Seattle, WA 98104-2433
Phone (206) 744-2020

Hospital & facility affiliations

  • Harborview Medical Center Hospital, Seattle, WA, CCN 500064

Merit-based Incentive Payment System (MIPS)

Final score
93.85 of 100Reported as apm
Quality
74.6
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: dpruitt96871@direct.ehre.uwmedicine.org

Organizations & group practices 1

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": "1225324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639612800000",
    "number": "1497908750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 9TH AVE # 359798",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 9TH AVE # 359798",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042420",
            "telephone_number": "206-520-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRUITT",
        "first_name": "DENA",
        "middle_name": "R",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-30",
        "last_updated": "2021-12-16",
        "certification_date": "2021-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60053140",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA60053140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.