Active NPI
Todd F Gunderson, MD
- Internal Medicine Physician
- Everett, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 33535
- Practice address
- 3901 Hoyt Ave
Everett, WA 98201-4918 - Phone
- (425) 259-0966
- NPI assigned
- Apr 12, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 33535 | WA | Primary |
Addresses
Primary practice location
3901 Hoyt Ave
Everett, WA 98201-4918
Mailing address
PO Box 5127
Everett, WA 98206-5127
Phone (425) 258-3900
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1015833 | 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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Northwestern University Feinberg Medical School, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3901 Hoyt Ave
Everett, WA 98201-4918
Phone (425) 339-5442
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33535 | WA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Polyclinic PLLC | Internal Medicine | Current | Accepting new patients |
| Optum Care Washington PLLC | Internal Medicine | Current | Accepting new patients |
| Optum Care Washington PLLC | Internal Medicine | Current | Accepting new patients |
| The Polyclinic PLLC | Internal Medicine | Current | Accepting new patients |
| Optum Care Washington PLLC | Past | Accepting new patients |
Locations
3901 Hoyt Ave
Everett, WA 98201
Phone (425) 258-3903
1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903
1145 Broadway
Seattle, WA 98122
1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299
1812 S J St
Ste 102
Tacoma, WA 98405
Phone (253) 552-4900
Interoperability endpoints
- tgunderson1292@direct.tecmc.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 and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Everett, WA
- NPI 1831186766
Internal Medicine
-
- Durable Medical Equipment & Medical Supplies
- Marysville, WA
- NPI 1194428425
Internal Medicine
-
- Durable Medical Equipment & Medical Supplies
- Tacoma, WA
- NPI 1831411487
Internal Medicine
-
- Ambulatory Surgical Clinic/Center
- Everett, WA
- NPI 1154318103
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355184000000",
"number": "1669436176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5127",
"city": "EVERETT",
"state": "WA",
"postal_code": "982065127",
"telephone_number": "425-258-3900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3901 HOYT AVE",
"city": "EVERETT",
"state": "WA",
"postal_code": "982014918",
"telephone_number": "425-259-0966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUNDERSON",
"first_name": "TODD",
"middle_name": "F",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-12",
"last_updated": "2012-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WA",
"license": "33535",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1015833",
"state": "WA"
}
],
"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 Dec 11, 2012; 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.