Individual provider Active NPI

Robert Charles Shirey, PA-C

  • Physician Assistant
  • Pasco, WA
National Provider Identifier
1538269378
Registry record updated Aug 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10004176 Issued in WA
Practice address
5304 N Road 68
Pasco, WA 99301-9189
Phone
(509) 543-9300
NPI assigned
Sep 22, 2006
Last updated
Aug 17, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10004176 WA Primary

Addresses

Primary practice location

5304 N Road 68
Pasco, WA 99301-9189

Mailing address

520 N 4TH Ave
Pasco, WA 99301-5257
Phone (509) 416-8849

Other identifiers 1

IdentifierTypeStateIssuer
1012882MedicaidWA

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
I20041020000964 WA Practitioner - Physician Assistant 5698736916 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

311 S L St
Tacoma, WA 98405-3720

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Jul 15, 2019 Accepting new patients
Multicare Health System CurrentSince Jul 15, 2019 Accepting new patients
Lourdes Hospital LLC CurrentSince Sep 1, 2018 Accepting new patients
Our Lady of Lourdes Health Center Past Accepting new patients
Our Lady of Lourdes Health Center Past Accepting new patients
Our Lady of Lourdes Hospital at Pasco Past Accepting new patients

Locations

32114 1st Ave S
Ste 103
Federal Way, WA 98003
Phone (253) 403-7277

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

1200 N 14th Ave
Pasco, WA 99301
Phone (509) 547-7536

507 N 5th Ave
Pasco, WA 99301
Phone (509) 543-1975

520 N 4th Ave
Pasco, WA 99301
Phone (509) 544-6140

5304 Road 68
Pasco, WA 99301
Phone (509) 543-9300

7425 Wrigley Dr
Ste 204
Pasco, WA 99301
Phone (509) 416-0027

1175 Carondelet Dr
Richland, WA 99354
Phone (509) 943-9104

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471392000000",
    "number": "1538269378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 N 4TH AVE",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993015257",
            "telephone_number": "509-416-8849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5304 N ROAD 68",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993019189",
            "telephone_number": "509-543-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIREY",
        "first_name": "ROBERT",
        "middle_name": "CHARLES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2016-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10004176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1012882",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasco, WA

Sources for this page

Verify at the official NPI Registry.