Individual provider Active NPI

Sean Ghidella, MD

  • Orthopaedic Hand Surgery Physician
  • Lakewood, WA
National Provider Identifier
1538135322
Registry record updated Oct 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X
License
MD00040711 Issued in WA
Practice address
7308 Bridgeport Way W
Suite 201
Lakewood, WA 98499-8000
Phone
(253) 582-7257
Fax
(253) 582-1617
NPI assigned
Feb 23, 2006
Last updated
Oct 19, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Hand Surgery Physician 207XS0106X MD00040711 WA Primary

Addresses

Primary practice location

7308 Bridgeport Way W
Suite 201
Lakewood, WA 98499-8000

Mailing address

805 Madison St
Suite 901
Seattle, WA 98104-1172
Phone (206) 264-8100

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
I20100706000215 WA Practitioner - Hand SurgeryPractitioner - Orthopedic Surgery 5294866315 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hand SurgeryAlso: Orthopedic Surgery
Education
Georgetown University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proliance Surgeons Inc P SGroup PAC ID 8527972900, 395 clinicians

Practice addresses (Care Compare)

7308 Bridgeport Way W
Suite 201
Lakewood, WA 98499-8000
Phone (253) 582-7257

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)44

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00040711WAMDOrthopaedic Hand Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc P S Hand Surgery Current Accepting new patients
Proliance Surgeons Inc P S CurrentSince Jul 1, 2010 Accepting new patients
Proliance Surgeons, Inc., P.S. CurrentSince Jul 1, 2010 Accepting new patients
Proliance Surgeons Inc., P.S. Past Accepting new patients

Locations

7308 Bridgeport Way W
Ste 201
Lakewood, WA 98499
Phone (253) 582-7257

1401 S Laventure Rd
Mount Vernon, WA 98274
Phone (360) 424-2400

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

1724 West Union Ave
Ste 100
Tacoma, WA 98405
Phone (253) 830-5200

Interoperability endpoints

  • Direct secure messaging: sean.ghidella.p73@direct.proliance.nextgenshare.com

Organizations & group practices 4

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 1

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": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318982400000",
    "number": "1538135322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 MADISON ST",
            "address_2": "SUITE 901",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041172",
            "telephone_number": "206-264-8100",
            "fax_number": "206-264-8689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7308 BRIDGEPORT WAY W",
            "address_2": "SUITE 201",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984998000",
            "telephone_number": "253-582-7257",
            "fax_number": "253-582-1617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHIDELLA",
        "first_name": "SEAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-23",
        "last_updated": "2011-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "WA",
            "license": "MD00040711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

Verify at the official NPI Registry.