Individual provider Active NPI

Nicolae Vadan, PA

  • Surgical Physician Assistant
  • Everett, WA
National Provider Identifier
1598083743
Registry record updated Oct 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA 60115651 Issued in WA
Practice address
1330 Rockefeller Ave
Suite 400
Everett, WA 98201-1684
Phone
(425) 261-4950
Fax
(425) 261-4951
NPI assigned
May 12, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA 60115651 WA Primary

Addresses

Primary practice location

1330 Rockefeller Ave
Suite 400
Everett, WA 98201-1684

Mailing address

PO Box 3360
Portland, OR 97208-3360
Phone (866) 366-2983

Other identifiers 2

IdentifierTypeStateIssuer
PA10003353OtherWAWSL
2007611MedicaidWA

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
I20101101001411 WA Practitioner - Physician Assistant 7416141676 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Washington School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3726 Broadway
Everett, WA 98201-3788

4225 Hoyt Ave
Everett, WA 98203-2351

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA 60115651WAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services- Washington CurrentSince Jan 1, 2011 Accepting new patients
Optum Care Washington PLLC CurrentSince Sep 8, 2015 Accepting new patients
Providence Health & Services - Washington CurrentSince Jan 1, 2011 Accepting new patients
Western Washington Medical Group, Inc PS CurrentSince Jan 27, 2022 Accepting new patients
Western Washington Medical Group, Inc PS CurrentSince Jan 27, 2022 Accepting new patients
Optum Care Washington PLLC CurrentSince Sep 8, 2015 Accepting new patients

Locations

1330 Rockefeller Ave
Ste 400
Everett, WA 98201
Phone (425) 261-4950

1728 W Marine View Dr
Ste 111
Everett, WA 98201

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

4225 Hoyt Ave
Ste A
Everett, WA 98203
Phone (425) 259-3122

1321 Colby Ave
Ofc
Everett, WA 98201
Phone (425) 261-4076

4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

Interoperability endpoints

  • Direct secure messaging: nvadan726869@direct.multicare.org

Organizations & group practices 8

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": "1273622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445385600000",
    "number": "1598083743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360",
            "telephone_number": "866-366-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 ROCKEFELLER AVE",
            "address_2": "SUITE 400",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011684",
            "telephone_number": "425-261-4950",
            "fax_number": "425-261-4951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VADAN",
        "first_name": "NICOLAE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-12",
        "last_updated": "2015-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA 60115651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WSL",
            "identifier": "PA10003353",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2007611",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.