NPIMap

Organization Active NPI

Pearl Plastic Surgery, PLLC

  • Ambulatory Surgical Clinic/Center
  • Olympia, WA
National Provider Identifier
1508573221
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
PEARL PLASTIC SURGERY, PLLC
Practice address
145 Lilly Road
Suite 102
Olympia, WA 98506
Phone
(360) 878-9300
Fax
(360) 878-9666
NPI assigned
Nov 2, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Authorized official

Name
Daniel Albershardt, MDNPI 1295056455
Title
Manager
Phone
(360) 878-9300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

145 Lilly Road
Suite 102
Olympia, WA 98506

Mailing address

145 Lilly Road
Suite 102
Olympia, WA 98506
Phone (360) 878-9300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Ambulatory surgical center certification: CCN 50C0001341

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
Pearl Plastic Surgery
Certification status
Active
Provider type (POS)
Ambulatory surgical center
Participating since
Apr 18, 2023
Last certification
Feb 23, 2023
Ownership / control type
Proprietary
Facility address
145 Lilly Rd NE Ste 101
olympia, WA 98506

National Provider Directory

National Provider Directory

Locations

145 Lilly Rd NE
#102
Olympia, WA 98506
Phone (360) 878-9300

145 Lilly Rd NE
#101
Olympia, WA 98506
Phone (360) 878-9300

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1667347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724630400000",
    "number": "1508573221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 LILLY ROAD",
            "address_2": "SUITE 102",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "98506",
            "telephone_number": "360-878-9300",
            "fax_number": "360-878-9666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 LILLY ROAD",
            "address_2": "SUITE 102",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "98506",
            "telephone_number": "360-878-9300",
            "fax_number": "360-878-9666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEARL PLASTIC SURGERY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-02",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A",
        "authorized_official_last_name": "ALBERSHARDT",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "360-878-9300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.