Individual provider Active NPI

Marciano Baul Capati Jr., MD

  • Family Medicine Physician
  • Selah, WA
National Provider Identifier
1508059486
Registry record updated Nov 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60114666 Issued in WA
Practice address
715 North Park Drive
Selah, WA 98942-1308
Phone
(509) 697-4827
Fax
(509) 697-9099
NPI assigned
Aug 23, 2007
Last updated
Nov 8, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD60114666 WA Primary

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

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101022000327 WA Practitioner - Family Practice 1658564638 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Overlake Medical Clinics LLCGroup PAC ID 7012808827, 423 clinicians

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services- Washington CurrentSince May 15, 2022 Accepting new patients
Overlake Medical Clinics, LLC Current Accepting new patients
Overlake Medical Clinics LLC CurrentSince Mar 27, 2017 Accepting new patients
Issaquah Obstetrics and Gynecology PLLC Past Accepting new patients
Yakima Hma Physician Management LLC Family Medicine Past Accepting new patients

Locations

10223 NE 10th St
Bellevue, WA 98004
Phone (425) 453-3288

1750 112th Ave NE
Ste B102
Bellevue, WA 98004
Phone (425) 688-5460

619 156th Ave SE
Bellevue, WA 98007
Phone (425) 637-3270

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

  • Direct secure messaging: mcapati2337438@wm.providencedirect.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289174400000",
    "number": "1508059486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "732 SUMMITVIEW AVE # 621",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023032",
            "telephone_number": "509-573-3448",
            "fax_number": "509-574-4481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 NORTH PARK DRIVE",
            "city": "SELAH",
            "state": "WA",
            "postal_code": "989421308",
            "telephone_number": "509-697-4827",
            "fax_number": "509-697-9099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPATI",
        "first_name": "MARCIANO",
        "middle_name": "BAUL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-23",
        "last_updated": "2010-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60114666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Selah, WA

Sources for this page

Verify at the official NPI Registry.