Mario V Cerpa, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00022221 Issued in WA

Practice address

1415 Kincaid St
Mt Vernon, WA 98273-4126

Phone

(360) 588-5550

Fax

(360) 588-5590

NPI assigned

Jun 23, 2006

Last updated

Aug 31, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Family Practice

Education

Other, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sea Mar Community Health CentersGroup PAC ID 7315831161, 235 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mcerpa450287@direct.multicare.org

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.

• Sea Mar Community Health Centers

  dba Sea Mar Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Aberdeen, WA
  • NPI 1811051170

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Mount Vernon, WA
  • NPI 1023247541

  Family Medicine

  NPD
• Sea Mar Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Spanaway, WA
  • NPI 1922624642
  NPD
• Family Health Centers

  • Federally Qualified Health Center (FQHC)
  • Okanogan, WA
  • NPI 1609804392
  NPD (past)
• Sea-Mar Community Health Center

  • Family Medicine Physician
  • Seattle, WA
  • NPI 1942358817
  NPD (past)

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251676800000",
    "number": "1558397406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34703",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241703",
            "telephone_number": "206-764-3335",
            "fax_number": "206-764-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 KINCAID ST",
            "city": "MT VERNON",
            "state": "WA",
            "postal_code": "982734126",
            "telephone_number": "360-588-5550",
            "fax_number": "360-588-5590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CERPA",
        "first_name": "MARIO",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2009-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00022221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8600389",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "132724",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James G Caviezel, DC
• Maria Victoria Cayabyab, D.O.
• Rhandy Ceballos, DO
• Alexa Nicole Reyes Celerian, DO
• Brianna Julieta Centeno, SLP-A
• Juan Enrique Cerrillo, SUDP
• Nicolas Cervantes, INTERPRETER
• Annushka Cesan, ARNP
• Nancy Henderson Chaffee, M.D.
• Frances T. Chalmers, M.D.

• Family Medicine Physician in Mount Vernon, WA
• Providers in Mount Vernon, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2009; 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.

Verify at the official NPI Registry.