Proliance Surgeons, Inc., P.S

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

601484763 Issued in WA

Legal business name

PROLIANCE SURGEONS, INC., P.S

Practice address

9730 3Rd Ave NE
Suite 201
Seattle, WA 98115-2023

Phone

(206) 526-9999

Fax

(206) 526-9995

NPI assigned

Apr 23, 2008

Organization subpart

No

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

Authorized official

Name

Mr. David G Fitzgerald

Title

Ceo

Phone

(206) 264-8100

Specialties & licenses 1

Addresses

Other names 1

• Puget Sound Ear, Nose and Throat Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 2

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

• James David Bruckner, MD

  • Orthopaedic Surgery Physician
  • Bellevue, WA
  • NPI 1154392942
  NPD
• Stephanie Peace Rezendes, PA-C

  • Surgical Physician Assistant
  • Edmonds, WA
  • NPI 1952703258
  NPD (past)

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

{
    "created_epoch": "1208908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429488000000",
    "number": "1649445420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 MADISON ST",
            "address_2": "SUITE 901",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041172",
            "telephone_number": "206-264-8100",
            "fax_number": "206-264-8689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9730 3RD AVE NE",
            "address_2": "SUITE 201",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981152023",
            "telephone_number": "206-526-9999",
            "fax_number": "206-526-9995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROLIANCE SURGEONS, INC., P.S",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-23",
        "last_updated": "2015-04-20",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "206-264-8100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "WA",
            "license": "601484763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Puget Sound Ear, Nose and Throat",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Proliance Surgeons Inc., P.S.
• Proliance Surgeons Inc., P.S.
• Proliance Surgeons Inc., P.S.
• Proliance Surgeons Inc., P.S.
• Proliance Surgeons, Inc., P.S
• Proliance Surgeons, Inc., P.S.
• Proliance Surgeons, Inc., P.S.
• Proliance Surgeons, Inc., P.S.
• Proliance Surgeons, Inc., P.S.
• Proliance Surgeons, Inc., P.S.

• Otolaryngology Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Otolaryngology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.