Active NPI
Nicholas C Welter, MD
- Sports Medicine (Family Medicine) Physician
- Bonney Lake, WA
National Provider Identifier
1598144404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Family Medicine) Physician
- License
- MD61505880
- Practice address
- 9230 Sky Island Dr E
Bonney Lake, WA 98391-7385 - Phone
- (253) 750-6000
- Fax
- (253) 750-6100
- NPI assigned
- May 26, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Family Medicine) Physician | 207QS0010X | MD188298 | OR | |
| Sports Medicine (Family Medicine) Physician | 207QS0010X | MD61505880 | WA | Primary |
| Family Medicine Physician | 207Q00000X | MD61505880 | WA |
Addresses
Primary practice location
9230 Sky Island Dr E
Bonney Lake, WA 98391-7385
Mailing address
9230 Sky Island Dr E
Bonney Lake, WA 98391-7385
Phone (253) 750-6000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2104658 | Medicaid | WA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | nwelter856410@fhsce.catholichealth.net | Direct | Franciscan Medical Group |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240530002457 | WA | Practitioner - Family Practice | 0345552485 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Washington School of Medicine, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
9230 Sky Island Dr E
FL 1
Bonney Lake, WA 98391-7385
Phone (253) 750-6022
Hospital & facility affiliations
- St Francis Community Hospital
- St Joseph Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD61505880 | WA | MD | Sports Medicine (Family Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Franciscan Medical Group | Current | Accepting new patients | |
| Franciscan Medical Group | Current | Accepting new patients | |
| Franciscan Medical Group | Family Medicine | Current | Accepting new patients |
| Franciscan Medical Group | Family Medicine | Past | Accepting new patients |
Locations
9230 Sky Island Dr E
Bonney Lake, WA 98391
Phone (253) 750-6000
9230 Sky Island Dr E
Fl 1
Bonney Lake, WA 98391
Phone (253) 750-6000
34503 9th Ave S
Ste 130
Federal Way, WA 98003
Phone (253) 835-5340
1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200
Organizations & group practices 4
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.
-
- Anesthesiology Physician
- Tacoma, WA
- NPI 1831358282
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723680000000",
"number": "1598144404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9230 SKY ISLAND DR E",
"city": "BONNEY LAKE",
"state": "WA",
"postal_code": "983917385",
"telephone_number": "253-750-6000",
"fax_number": "253-750-6100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9230 SKY ISLAND DR E",
"city": "BONNEY LAKE",
"state": "WA",
"postal_code": "983917385",
"telephone_number": "253-750-6000",
"fax_number": "253-750-6100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELTER",
"first_name": "NICHOLAS",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-05-26",
"last_updated": "2024-08-15",
"certification_date": "2024-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "207QS0010X",
"taxonomy_group": "",
"desc": "Family Medicine, Sports Medicine",
"state": "OR",
"license": "MD188298",
"primary": false
},
{
"code": "207QS0010X",
"taxonomy_group": "",
"desc": "Family Medicine, Sports Medicine",
"state": "WA",
"license": "MD61505880",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "MD61505880",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2104658",
"state": "WA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "nwelter856410@fhsce.catholichealth.net",
"affiliation": "Y",
"affiliationName": "Franciscan Medical Group",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "9230 Sky Island Dr E",
"city": "Bonney Lake",
"state": "WA",
"country_code": "US",
"postal_code": "983917385",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Bonney Lake, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; 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.