Active NPI
David Isaac Golembiowski, ARNP
- Acute Care Nurse Practitioner
- Puyallup, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acute Care Nurse Practitioner
- License
- AP60911665
- Practice address
- 401 15TH Ave SE
Puyallup, WA 98372-3715 - Phone
- (253) 697-7655
- Fax
- (253) 697-2919
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine Registered Nurse | 163WC0200X | RN00141784 | WA | |
| Acute Care Nurse Practitioner | 363LA2100X | AP60911665 | WA | Primary |
Addresses
Primary practice location
401 15TH Ave SE
Puyallup, WA 98372-3715
Mailing address
401 15TH Ave SE
Puyallup, WA 98372-3715
Phone (253) 697-7655
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528087186 | Medicaid | WA |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
407 14TH Ave SE
Puyallup, WA 98372-3770
Phone (253) 697-4000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP60911665 | WA | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cogent Healthcare of Washington, PC | Current | Accepting new patients | |
| South Sound Inpatient Physicians PLLC | Current | Accepting new patients | |
| Multicare Health System | Past | Accepting new patients |
Locations
202 N Division St
Auburn, WA 98001
Phone (253) 333-2562
16251 Sylvester Rd SW
Burien, WA 98166
Phone (206) 244-9970
407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000
2000 Hospital Dr
Sedro Woolley, WA 98284
Phone (360) 856-6021
Interoperability endpoints
- dgolembiowski1058335@wm.providencedirect.org
Organizations & group practices 3
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.
-
- Internal Medicine Physician
- Vancouver, WA
- NPI 1023285756
-
- Internal Medicine Physician
- Vancouver, WA
- NPI 1861430522
-
- General Acute Care Hospital
- Puyallup, WA
- NPI 1841231461
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Tacoma, WA
- NPI 1366556227
-
- General Acute Care Hospital
- Puyallup, WA
- NPI 1841231461
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661299200000",
"number": "1528087186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 15TH AVE SE",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983723715",
"telephone_number": "253-697-7655",
"fax_number": "253-697-2919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 15TH AVE SE",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983723715",
"telephone_number": "253-697-7655",
"fax_number": "253-697-2919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLEMBIOWSKI",
"first_name": "DAVID",
"middle_name": "ISAAC",
"name_prefix": "Mr.",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2022-08-24",
"certification_date": "2022-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "163WC0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Critical Care Medicine",
"state": "WA",
"license": "RN00141784",
"primary": false
},
{
"code": "363LA2100X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Acute Care",
"state": "WA",
"license": "AP60911665",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1528087186",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Puyallup, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.