Individual provider Active NPI

David Isaac Golembiowski, ARNP

  • Acute Care Nurse Practitioner
  • Puyallup, WA
National Provider Identifier
1528087186
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP60911665 Issued in WA
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

Updated by the provider on Aug 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
1528087186MedicaidWA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200115002042 WA Practitioner - Nurse Practitioner 0446685796 Reassigns benefits to 1 organization

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

LicenseStateTypeSpecialty
AP60911665WAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cogent Healthcare of Washington, PC CurrentSince Jun 1, 2021 Accepting new patients
South Sound Inpatient Physicians PLLC CurrentSince Feb 2, 2023 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

  • Direct secure messaging: 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.

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": "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

Verify at the official NPI Registry.