NPIMap

Individual provider Active NPI

Daniel J Sitkowski, P.A.C.

  • Physician Assistant
  • Seaside, OR
National Provider Identifier
1639156854
Registry record updated Sep 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA150245 Issued in OR
Practice address
725 S Wahanna Rd
Seaside, OR 97138-7735
Phone
(503) 717-7000
NPI assigned
Dec 29, 2005
Last updated
Sep 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2020

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 50-00-0164 OH
Physician Assistant 363A00000X PA150245 OR Primary

Addresses

Primary practice location

725 S Wahanna Rd
Seaside, OR 97138-7735

Mailing address

PO Box 3397
Portland, OR 97208-3397

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dsitkowski131327@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100106000573 OR Practitioner - Physician Assistant 6709988231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

113 S Hwy 101
Warrenton, OR 97146-9314
Phone (503) 861-6500

725 S Wahanna Rd
Seaside, OR 97138-7735
Phone (503) 717-7000

727 S Wahanna Rd
Seaside, OR 97138-7735
Phone (503) 717-7000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Oregon CurrentSince Dec 15, 2009 Accepting new patients
Providence Health & Services Oregon CurrentSince Dec 15, 2009 Accepting new patients
Precision Orthopaedic Specialties, Inc. Past Accepting new patients
Providence Health & Services Oregon Past Accepting new patients
University Primary Care Practices Inc Past Accepting new patients

Locations

725 S Wahanna Rd
Seaside, OR 97138
Phone (503) 717-7000

727 S Wahanna Rd
Seaside, OR 97138
Phone (503) 717-7000

Organizations & group practices 5

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 9

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": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1639156854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3397",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S WAHANNA RD",
            "city": "SEASIDE",
            "state": "OR",
            "postal_code": "971387735",
            "telephone_number": "503-717-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SITKOWSKI",
        "first_name": "DANIEL",
        "middle_name": "J",
        "credential": "P.A.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-29",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50-00-0164",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA150245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dsitkowski131327@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "725 S Wahanna Rd",
            "city": "Seaside",
            "state": "OR",
            "country_code": "US",
            "postal_code": "971387735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seaside, OR

Sources for this page

Verify at the official NPI Registry.