Jonathan W Fish, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00039820 Issued in WA

Practice address

1990 Hospital Drive
Suite 100
Sedro-Wooley, WA 98284-9315

Phone

(360) 856-4141

Fax

(360) 856-4145

NPI assigned

Mar 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA, CA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family Practice

Education

Loma Linda University School of Medicine, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North State Hospitalist Medical Group IncGroup PAC ID 2668893447, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Medical Center of Mt Shasta Hospital, Mount Shasta, CA, CCN 051319
• Shasta Regional Medical Center Hospital, Redding, CA, CCN 050764
• Mercy Medical Center of Mt Shasta Nursing home, CCN 05Z319

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• North State Hospitalist Medical Group, Inc

  • Hospitalist Physician
  • Mount Shasta, CA
  • NPI 1598305682
  Medicare reassignment Care Compare group
• Kittitas County Public Hospital Dist 1

  • Critical Access Hospital
  • Ellensburg, WA
  • NPI 1356375307
  Medicare reassignment NPD
• South Sound Inpatient Physicians PLLC

  • Internal Medicine Physician
  • Vancouver, WA
  • NPI 1023285756

  Family Medicine

  Medicare reassignment NPD
• Cogent Healthcare of Washington, PC

  • Internal Medicine Physician
  • Vancouver, WA
  • NPI 1861430522

  Family Medicine

  NPD
• Kittitas County Public Hosp Dist 1

  • Urology Physician
  • Ellensburg, WA
  • NPI 1437029832
  NPD
• Kittitas County Public Hospital Dist 1

  • Specialist
  • Ellensburg, WA
  • NPI 1003016825
  NPD
• South Sound Inpatient Physicians PLLC

  • Internal Medicine Physician
  • Bremerton, WA
  • NPI 1831366566

  Family Medicine

  NPD
• South Sound Inpatient Physicians PLLC

  • Internal Medicine Physician
  • Hillsboro, OR
  • NPI 1508023789

  Family Medicine

  NPD
• Dietrich & Smith Clinic Inc P S

  • Primary Care Clinic/Center
  • Sedro Woolley, WA
  • NPI 1336145846
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Dignity Health

  • Critical Access Hospital
  • Mount Shasta, CA
  • NPI 1518085430
  Care Compare affiliation
• Prime Healthcare Services - Shasta LLC

  • General Acute Care Hospital
  • Redding, CA
  • NPI 1205089026
  Care Compare affiliation

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

{
    "created_epoch": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629039599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 HOSPITAL DRIVE",
            "address_2": "SUITE 100",
            "city": "SEDRO-WOOLEY",
            "state": "WA",
            "postal_code": "982849315",
            "telephone_number": "360-856-4141",
            "fax_number": "360-856-4145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1990 HOSPITAL DRIVE",
            "address_2": "SUITE 100",
            "city": "SEDRO-WOOLEY",
            "state": "WA",
            "postal_code": "982849315",
            "telephone_number": "360-856-4141",
            "fax_number": "360-856-4145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISH",
        "first_name": "JONATHAN",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00039820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8275984",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Lynn Rose, LPN

• Family Medicine Physician in Sedro-Wooley, WA
• Providers in Sedro-Wooley, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.