Individual provider Active NPI

David F Pavlik, D.O

  • Pediatrics Physician
  • Bellingham, WA
National Provider Identifier
1548502735
Registry record updated Oct 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
OP60645105 Issued in WA
Practice address
4545 Cordata Pkwy
Bellingham, WA 98226-7263
Phone
(360) 738-2200
NPI assigned
Mar 26, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X OP60645105 WA Primary

Addresses

Primary practice location

4545 Cordata Pkwy
Bellingham, WA 98226-7263

Mailing address

1115 SE 164TH Ave
Dept 358
Vancouver, WA 98683-9324
Phone (360) 729-1253

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
I20160914002115 WA Practitioner - Pediatric Medicine 5092001263 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OP60645105WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth Pediatrics CurrentSince Aug 22, 2016 Accepting new patients
Peacehealth CurrentSince Aug 22, 2016 Accepting new patients

Locations

3015 Squalicum Pkwy
Ste 100
Bellingham, WA 98225
Phone (360) 715-4186

4545 Cordata Pkwy
Bellingham, WA 98226
Phone (360) 752-5646

1115 SE 164th Ave
Dept 358
Vancouver, WA 98683
Phone (360) 729-1253

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.

NPI Registry JSON

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

{
    "created_epoch": "1364256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476230400000",
    "number": "1548502735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 SE 164TH AVE",
            "address_2": "DEPT 358",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986839324",
            "telephone_number": "360-729-1253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 CORDATA PKWY",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982267263",
            "telephone_number": "360-738-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVLIK",
        "first_name": "DAVID",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-26",
        "last_updated": "2016-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "OP60645105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

Verify at the official NPI Registry.