Individual provider Active NPI

Robert Jason Thomas Perry, MD

  • Vascular Surgery Physician
  • Olympia, WA
National Provider Identifier
1508872540
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
MD60704466 Issued in WA
Practice address
128 Lilly Rd NE Ste 205
Olympia, WA 98506-7400
Phone
(360) 493-7444
Fax
(360) 236-7929
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X MD60704466 WA Primary

Addresses

Primary practice location

128 Lilly Rd NE Ste 205
Olympia, WA 98506-7400

Mailing address

128 Lilly Rd NE Ste 205
Olympia, WA 98506-7400

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
I20170307001558 WA Practitioner - Vascular Surgery 6002190261 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
University of Washington School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

128 Lilly Rd NE
Suite 205
Olympia, WA 98506-7400
Phone (306) 754-3380

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10
Varicose vein removal13
Leg revascularization (restoring blood flow)32
Removal of tissue13

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince Feb 1, 2017 Accepting new patients
Providence Health & Services Washington Past Accepting new patients

Locations

1921 Sumner Ave
Aberdeen, WA 98520
Phone (360) 533-6447

1018 Capitol Way S
Ste 300
Olympia, WA 98501
Phone (360) 486-6508

128 Lilly Rd NE
Ste 205
Olympia, WA 98506
Phone (360) 493-7444

525 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8550

Interoperability endpoints

  • Direct secure messaging: rperry779399@wm.providencedirect.org

Organizations & group practices 2

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 6

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1508872540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 LILLY RD NE STE 205",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985067400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 LILLY RD NE STE 205",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985067400",
            "telephone_number": "360-493-7444",
            "fax_number": "360-236-7929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "ROBERT",
        "middle_name": "JASON THOMAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "WA",
            "license": "MD60704466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.