Active NPI
William M. Bomberger, PA-C
- Medical Physician Assistant
- Spokane, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA10004622
- Practice address
- 1001 W 2ND Ave
Spokane, WA 99201-4503 - Phone
- (509) 835-1205
- Fax
- (509) 835-1208
- NPI assigned
- Jul 13, 2006
- Last updated
- May 20, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA-1486 | ID | |
| Medical Physician Assistant | 363AM0700X | PA10004622 | WA | Primary |
Addresses
Primary practice location
1001 W 2ND Ave
Spokane, WA 99201-4503
Mailing address
611 N Iron Bridge Way Ste 300
Spokane, WA 99202-4932
Phone (509) 444-8888
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8427098 | Medicaid | WA |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1001 W 2ND Ave
Spokane, WA 99201-4503
Phone (509) 835-1206
3919 N Maple St
Spokane, WA 99205-1349
Phone (509) 444-8888
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA-1486 | ID | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Health Association of Spokane | Current | Accepting new patients | |
| Community Health Association of Spokane | Current | Accepting new patients | |
| Puget Sound Family Physicians | Past | Accepting new patients | |
| Community Health Association of Spokane | Past | Accepting new patients | |
| King County Public Hospital District No. 2 | Past | Accepting new patients |
Locations
803 S Main St
Ste 120
Moscow, ID 83843
Phone (208) 848-8300
1720 2nd St
Cheney, WA 99004
Phone (207) 865-8002
1001 W 2nd Ave
Spokane, WA 99201
Phone (509) 835-1205
3919 N Maple St
Spokane, WA 99205
Phone (509) 326-6900
5620 S Regal St
Ste 11
Spokane, WA 99223
Phone (509) 340-1590
5921 N Market St
Spokane, WA 99208
Phone (509) 487-1604
611 N Iron Bridge Way
Ste 300
Spokane, WA 99202
914 W Carlisle Ave
Spokane, WA 99205
Phone (509) 325-0393
1502 N Vercler Rd
Spokane Valley, WA 99216
Phone (509) 444-8204
15812 E Indiana Ave
Ste 101
Spokane Valley, WA 99216
Interoperability endpoints
- william.bomberger.1@11411.direct.athenahealth.com
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.
-
- Federally Qualified Health Center (FQHC)
- Spokane, WA
- NPI 1326005851
-
- Federally Qualified Health Center (FQHC)
- Spokane, WA
- NPI 1417731951
-
- Federally Qualified Health Center (FQHC)
- Spokane, WA
- NPI 1679363592
-
dba EvergreenHealth at Home Physical Therapy
- Physical Therapist
- Kirkland, WA
- NPI 1356920946
-
- Family Medicine Physician
- Edmonds, WA
- NPI 1083643340
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621468800000",
"number": "1639194079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 N IRON BRIDGE WAY STE 300",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992024932",
"telephone_number": "509-444-8888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 W 2ND AVE",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992014503",
"telephone_number": "509-835-1205",
"fax_number": "509-835-1208"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOMBERGER",
"first_name": "WILLIAM",
"middle_name": "M.",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-13",
"last_updated": "2021-05-20",
"certification_date": "2021-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "ID",
"license": "PA-1486",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WA",
"license": "PA10004622",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8427098",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2021; 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.