Individual provider Active NPI

Erin R. Naidu, PA-C

  • Surgical Physician Assistant
  • Seattle, WA
National Provider Identifier
1619203114
Registry record updated Dec 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA60306131 Issued in WA
Practice address
515 Minor Ave
Suite 200
Seattle, WA 98104-2120
Phone
(206) 215-2580
Fax
(206) 215-2581
NPI assigned
Oct 19, 2009
Last updated
Dec 29, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 15-01343 KS
Surgical Physician Assistant 363AS0400X PA60306131 WA Primary

Addresses

Primary practice location

515 Minor Ave
Suite 200
Seattle, WA 98104-2120

Mailing address

805 Madison St
Suite 901
Seattle, WA 98104-1172
Phone (206) 264-8100

Other identifiers 1

IdentifierTypeStateIssuer
15-01343OtherKSKS LICENSE

Other names 1

  • Erin R. Gurss Former name

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
I20140402002228 WA Practitioner - Physician Assistant 2163563107 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

12040 NE 128TH St
Kirkland, WA 98034-3013

12040 NE 128TH St Ms
Suite 55
Kirkland, WA 98034-3013

12710 Totem Lake Blvd NE
Kirkland, WA 98034-2907
Phone (425) 821-4040

14720 Main St NE
Suite 109
Duvall, WA 98019-8460
Phone (425) 788-4889

14841 179TH Ave SE
Monroe, WA 98272-1127

16916 140TH Ave NE
Woodinville, WA 98072-6957

18151 68TH Ave NE
Suite 100
Kenmore, WA 98028-2835
Phone (425) 485-6561

1909 214TH St SE
Suite 110
Bothell, WA 98021-4412
Phone (425) 488-4988

8980 161St Ave NE
Redmond, WA 98052-7554

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
15-01343KSMDPhysician Assistant
PA60306131WAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc P S Surgical CurrentSince Jan 1, 2017 Accepting new patients
Multicare Health System Physician Assistant CurrentSince Jul 8, 2019 Accepting new patients
Proliance Surgeons, Inc., P.S. CurrentSince Jan 1, 2017 Accepting new patients
King County Public Hospital District No. 2 CurrentSince Mar 1, 2021 Accepting new patients
Multicare Health System CurrentSince Jul 8, 2019 Accepting new patients
DRX Wa Urgent Care Providers PLLC Physician Assistant CurrentSince Mar 1, 2014 Accepting new patients
King County Public Hospital District No. 2 CurrentSince Mar 1, 2021 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients

Locations

1909 214th St SE
Ste 110
Bothell, WA 98021
Phone (425) 488-4988

14720 Main St NE
Ste 109
Duvall, WA 98019
Phone (425) 788-4889

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

510 8th Ave NE
Ste 200
Issaquah, WA 98029
Phone (425) 392-3030

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

515 Minor Ave
Ste 200
Seattle, WA 98104
Phone (206) 386-9615

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

9000 Holman Rd NW
Ste A1
Seattle, WA 98117
Phone (206) 706-9001

Organizations & group practices 12

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.

Hospital & facility affiliations 1

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": "1255910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482969600000",
    "number": "1619203114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 MADISON ST",
            "address_2": "SUITE 901",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041172",
            "telephone_number": "206-264-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 MINOR AVE",
            "address_2": "SUITE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042120",
            "telephone_number": "206-215-2580",
            "fax_number": "206-215-2581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAIDU",
        "first_name": "ERIN",
        "middle_name": "R.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-19",
        "last_updated": "2016-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-01343",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA60306131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KS LICENSE",
            "identifier": "15-01343",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "GURSS",
            "middle_name": "R.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.