Organization Active NPI

Pacific Comprehensive Health PLLC

  • Primary Care Clinic/Center
  • Kennewick, WA
National Provider Identifier
1659096964
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PACIFIC COMPREHENSIVE HEALTH PLLC
Practice address
7103 W Grandridge Blvd Ste D
Kennewick, WA 99336-6713
Phone
(509) 676-2160
NPI assigned
Oct 10, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Authorized official

Name
Srinivas Mascal, MD
Title
Physician
Phone
(509) 676-2160

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

7103 W Grandridge Blvd Ste D
Kennewick, WA 99336-6713

Mailing address

7103 W Grandridge Blvd Ste D
Kennewick, WA 99336-6713
Phone (509) 676-2160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221221000782 WA Part B Supplier - Clinic/Group Practice 9931579646 Receives reassigned benefits from 1 practitioner
Practice locations: Kennewick, WA; Pasco, WA

National Provider Directory

National Provider Directory

Locations

7103 W Grandridge Blvd
Ste D
Kennewick, WA 99336
Phone (509) 676-2160

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1665360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739491200000",
    "number": "1659096964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7103 W GRANDRIDGE BLVD STE D",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993366713",
            "telephone_number": "509-676-2160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7103 W GRANDRIDGE BLVD STE D",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993366713",
            "telephone_number": "509-676-2160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC COMPREHENSIVE HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-10",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A",
        "authorized_official_last_name": "MASCAL",
        "authorized_official_first_name": "SRINIVAS",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "509-676-2160",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2025; 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.