Marciano Baul Capati Jr., MD
Individual provider Active NPI Family Medicine Physician · Selah, WA
NPI 1508059486 · NPPES record last updated Nov 8, 2010
Key facts
- NPI
- 1508059486
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- MD60114666 (WA)
- Practice address
- 715 North Park Drive
Selah, WA 98942-1308 - Phone
- (509) 697-4827
- Fax
- (509) 697-9099
- NPI assigned
- Aug 23, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Overlake Medical Clinics LLC
Providence Health and Services- Washington
Practice addresses (Care Compare)
17209 Redmond Way
Redmond, WA 98052-4404
Phone (425) 635-6400
1750 112TH Ave NE
Suite B102
Bellevue, WA 98004-3772
Phone (425) 688-5460
19200 N Kelsey St
Monroe, WA 98272-1431
Phone (360) 794-7994
5708 E Lake Samm Pkwy SE
Issaquah, WA 98029-8942
Phone (425) 688-5488
Hospital & facility affiliations
- Overlake Hospital Medical Center & Clinics
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101022000327 | WA | Practitioner - Family Practice | 1658564638 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD60114666 | WA | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Overlake Medical Clinics, LLC | Current | Accepting new patients | |
| Overlake Medical Clinics LLC | Current |
Accepting new patients | |
| Providence Health & Services- Washington | Current |
Accepting new patients | |
| Yakima Hma Physician Management LLC | Family Medicine | Past | Accepting new patients |
| Issaquah Obstetrics and Gynecology PLLC | Past | Accepting new patients |
Locations
619 156th Ave SE
Bellevue, WA 98007
Phone (425) 637-3270
1750 112th Ave NE
Ste B102
Bellevue, WA 98004
Phone (425) 688-5460
10223 NE 10th St
Bellevue, WA 98004
Phone (425) 453-3288
5708 E Lake Sammamish Pkwy SE
Ste 102
Issaquah, WA 98029
Phone (425) 688-5488
6520 226th Pl SE
Ste 150
Issaquah, WA 98027
Phone (425) 688-5777
19200 N Kelsey St
Monroe, WA 98272
Phone (360) 794-5555
4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330
17209 Redmond Way
Redmond, WA 98052
Phone (425) 635-6400
Interoperability endpoints
- mcapati2337438@wm.providencedirect.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD60114666 | WA | Yes |
Addresses
Primary practice location
715 North Park Drive
Selah, WA 98942-1308
Mailing address
732 Summitview Ave # 621
Yakima, WA 98902-3032
Phone (509) 573-3448
Other providers in Selah, WA
- Samantha Grace Blomdahl
- Julaine Borchert
- Tammy Lynn Brack
- Rebecca Lynn Brown
- Jack Calvert
- Haida Denise Caruso
- Arlene Benedicto Castro
- Robin Marie Cavanaugh
- Paul Edward Cepe
- Joe Charles-Mercado
All providers in Selah, WA · Family Medicine Physician in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 8, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.