Individual provider Active NPI

Steven Charles Rautman, PHD

  • Psychologist
  • Mill Creek, WA
National Provider Identifier
1598823940
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY00001067 Issued in WA
Practice address
15418 Main St
Suite 301
Mill Creek, WA 98012
Phone
(425) 385-3262
Fax
(425) 357-0924
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY00001067 WA Primary

Addresses

Primary practice location

15418 Main St
Suite 301
Mill Creek, WA 98012

Mailing address

15418 Main St
Suite 301
Mill Creek, WA 98012
Phone (425) 385-3262

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050921000477 WA Practitioner - Clinical Psychologist 8022042894 Practice locations: Lake Stevens, WA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2611 121St Ave SE
Lake Stevens, WA 98258-5170
Phone (425) 385-3262

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY00001067WAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Consulting Group, Inc. Past Accepting new patients
Jennifer Gross, PSYD, Inc PastSince Feb 6, 2022 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": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598823940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15418 MAIN ST",
            "address_2": "SUITE 301",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "98012",
            "telephone_number": "425-385-3262",
            "fax_number": "425-357-0924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15418 MAIN ST",
            "address_2": "SUITE 301",
            "city": "MILL CREEK",
            "state": "WA",
            "postal_code": "98012",
            "telephone_number": "425-385-3262",
            "fax_number": "425-357-0924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAUTMAN",
        "first_name": "STEVEN",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY00001067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Creek, WA

Sources for this page

Verify at the official NPI Registry.