Individual provider Active NPI

Barry C Stewart, MD

  • Gynecology Physician
  • Renton, WA
National Provider Identifier
1568478337
Registry record updated Jan 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
MD00015615 Issued in WA
Practice address
14410 SE Petrovitsky Rd
Ste 104
Renton, WA 98058-8900
Phone
(425) 656-4242
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X MD00015615 WA Primary

Addresses

Primary practice location

14410 SE Petrovitsky Rd
Ste 104
Renton, WA 98058-8900

Mailing address

3600 Lind Ave SW
Ste 100
Renton, WA 98055-4934
Phone (425) 656-5412

Other identifiers 1

IdentifierTypeStateIssuer
8244402MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00015615WAMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Gynecology Specialists, PC Past Accepting new patients
Pacific Gynecology Specialists, PC Past Accepting new patients

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200873600000",
    "number": "1568478337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 LIND AVE SW",
            "address_2": "STE 100",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980554934",
            "telephone_number": "425-656-5412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14410 SE PETROVITSKY RD",
            "address_2": "STE 104",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980588900",
            "telephone_number": "425-656-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "BARRY",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2008-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "WA",
            "license": "MD00015615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8244402",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.