Active NPI
Todd W. Havener, M.D.
- Orthopaedic Hand Surgery Physician
- Everett, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Hand Surgery Physician
- License
- MD00043648
- Practice address
- 1100 Pacific Ave
Suite 300
Everett, WA 98201-4261 - Phone
- (425) 339-2433
- Fax
- (425) 339-8273
- NPI assigned
- Mar 16, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | MD00043648 | WA | |
| Orthopaedic Hand Surgery Physician | 207XS0106X | MD00043648 | WA | Primary |
Addresses
Primary practice location
1100 Pacific Ave
Suite 300
Everett, WA 98201-4261
Mailing address
805 Madison St
Suite 901
Seattle, WA 98104-1172
Phone (206) 264-8100
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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Orthopedic Surgery
- Education
- Medical College of Wisconsin, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1100 Pacific Ave
Suite 300
Everett, WA 98201-4261
Phone (425) 339-2433
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Upper limb (arm) arthroscopy (minimally invasive joint repair) | 12 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00043648 | WA | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Proliance Surgeons Inc P S | Orthopaedic Surgery | Current | Accepting new patients |
| Proliance Surgeons, Inc., P.S. | Current | Accepting new patients | |
| Optum Care Washington PLLC | Current | Accepting new patients | |
| Optum Care Washington PLLC | Current | Accepting new patients | |
| Proliance Surgeons Inc P S | Orthopaedic Surgery | Current | Accepting new patients |
Locations
1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903
3102 Colby Ave
Everett, WA 98201
Phone (425) 258-8110
1100 Pacific Ave
Ste 300
Everett, WA 98201
Phone (425) 337-7000
805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100
Interoperability endpoints
- thavener125192@wm.providencedirect.org
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 and National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Seattle, WA
- NPI 1023170313
-
- Multi-Specialty Clinic/Center
- Everett, WA
- NPI 1831186766
-
- Durable Medical Equipment & Medical Supplies
- Marysville, WA
- NPI 1194428425
-
- Orthopaedic Surgery Physician
- Renton, WA
- NPI 1235091463
-
- Ophthalmology Physician
- Bellevue, WA
- NPI 1841568946
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598486400000",
"number": "1659340289",
"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": "1100 PACIFIC AVE",
"address_2": "SUITE 300",
"city": "EVERETT",
"state": "WA",
"postal_code": "982014261",
"telephone_number": "425-339-2433",
"fax_number": "425-339-8273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAVENER",
"first_name": "TODD",
"middle_name": "W.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-16",
"last_updated": "2020-08-27",
"certification_date": "2020-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "WA",
"license": "MD00043648",
"primary": false
},
{
"code": "207XS0106X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Hand Surgery",
"state": "WA",
"license": "MD00043648",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2020; 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.