Individual provider Active NPI

Robert T Brown, PAC

  • Medical Physician Assistant
  • Brewster, WA
National Provider Identifier
1649232885
Registry record updated Nov 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA10003558 Issued in WA
Practice address
507 Hospital Way
Brewster, WA 98812-0507
Phone
(509) 689-2517
Fax
(509) 689-2086
NPI assigned
Apr 4, 2006
Last updated
Nov 20, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA10003558 WA Primary

Addresses

Primary practice location

507 Hospital Way
Brewster, WA 98812-0507

Mailing address

PO Box 577
Brewster, WA 98812-0577
Phone (509) 689-2517

Other identifiers 2

IdentifierTypeStateIssuer
8437626MedicaidWA
PA10003558OtherWALICENSE NUMBER

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
I20060522000014 WA Practitioner - Physician Assistant 7113938556 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10 Ros Cir
Republic, WA 99166-5002
Phone (509) 775-3245

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
29.6 of 100Reported as group
Quality
32.46
Improvement activities
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA10003558WAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ferry County Public Hospital District No 1 CurrentSince Mar 16, 2024 Accepting new patients
Ferry County Public Hospital District No 1 CurrentSince Mar 16, 2024 Accepting new patients

Locations

10 Ros Cir
Republic, WA 99166
Phone (509) 775-3153

36 Klondike Rd
Republic, WA 99166
Phone (509) 775-3153

Interoperability endpoints

  • Direct secure messaging: bob.brown@ferrycohealth.com

Organizations & group practices 3

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": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258675200000",
    "number": "1649232885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 577",
            "city": "BREWSTER",
            "state": "WA",
            "postal_code": "988120577",
            "telephone_number": "509-689-2517",
            "fax_number": "509-689-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 HOSPITAL WAY",
            "city": "BREWSTER",
            "state": "WA",
            "postal_code": "988120507",
            "telephone_number": "509-689-2517",
            "fax_number": "509-689-2086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "ROBERT",
        "middle_name": "T",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2009-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10003558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8437626",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "PA10003558",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brewster, WA

Sources for this page

Verify at the official NPI Registry.