NPIMap

Organization Active NPI

Surgical Associates Northwest, PC

  • Ambulatory Surgical Clinic/Center
  • Federal Way, WA
National Provider Identifier
1629016555
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SURGICAL ASSOCIATES NORTHWEST, PC
Practice address
34612 6TH Ave S
Suite 100
Federal Way, WA 98003-6704
Phone
(253) 661-2594
NPI assigned
Jun 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Authorized official

Name
Pamela Stanfill
Title
Billing Manager
Phone
(253) 661-2594

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X WA Primary
Multi-Specialty Clinic/Center 261QM1300X MD00013065 WA

Addresses

Primary practice location

34612 6TH Ave S
Suite 100
Federal Way, WA 98003-6704

Mailing address

34612 6TH Ave S
Suite 100
Federal Way, WA 98003-6704
Phone (253) 661-2594

Other identifiers 1

IdentifierTypeStateIssuer
7134158MedicaidWA

Other names 1

  • RAINIER SURGICAL CENTER Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051229000773 WA Part B Supplier - Ambulatory Surgical Center 3971596024 Receives reassigned benefits from 1 practitioner
Practice locations: Federal Way, WA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Rainier Surgical CenterCCN 50C0001253
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D0629008Surgical Associates Northwest Division of Urology34612 6TH Avenue South Ste 210, Federal Way, WA 98003ComplianceApr 4, 2028

National Provider Directory

National Provider Directory
Tax ID family
Surgical Associates Northwest PC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

222 2nd St NE
Auburn, WA 98002
Phone (253) 333-2737

34612 6th Ave S
#102
Federal Way, WA 98003

34612 6th Ave S
Ste 100
Federal Way, WA 98003
Phone (253) 237-0460

34612 6th Ave S
Ste 210
Federal Way, WA 98003
Phone (253) 927-1882

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 20

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720742400000",
    "number": "1629016555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34612 6TH AVE S",
            "address_2": "SUITE 100",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036704",
            "telephone_number": "253-661-2594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34612 6TH AVE S",
            "address_2": "SUITE 100",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036704",
            "telephone_number": "253-661-2594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL ASSOCIATES NORTHWEST, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A",
        "authorized_official_last_name": "STANFILL",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "253-661-2594"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "WA",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "WA",
            "license": "MD00013065",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7134158",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RAINIER SURGICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.