Individual provider Active NPI

Geoffrey Louis Tyson, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Mountlake Terrace, WA
National Provider Identifier
1679610778
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X
License
MD00021183 Issued in WA
Practice address
6808 220TH St SW Ste 201
Mountlake Terrace, WA 98043-2187
Phone
(360) 839-6778
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD00021183 WA
Addiction Medicine (Anesthesiology) Physician 207LA0401X MD00021183 WA
Pain Medicine (Anesthesiology) Physician 207LP2900X MD00021183 WA Primary

Addresses

Primary practice location

6808 220TH St SW Ste 201
Mountlake Terrace, WA 98043-2187

Mailing address

6808 220TH St SW Ste 201
Mountlake Terrace, WA 98043-2187
Phone (360) 839-6778

Other identifiers 1

IdentifierTypeStateIssuer
P00184334OtherWARAILROAD MEDICARE

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041217000844 WA Practitioner - AnesthesiologyPractitioner - Pain ManagementPractitioner - Interventional Pain Management 1456318732 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pain Management
Education
Temple University School of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sound Pain AllianceGroup PAC ID 0941565162, 43 clinicians

Practice addresses (Care Compare)

4029 Northwest Ave
Suite 301
Bellingham, WA 98226-9077
Phone (360) 752-0518

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00021183WAMDAddiction Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc., P.S. Pain Medicine CurrentSince Aug 1, 2016 Accepting new patients
Proliance Surgeons Inc P S Current Accepting new patients
Sound Pain Alliance CurrentSince Aug 1, 2022 Accepting new patients
Sound Pain Alliance Pain Medicine CurrentSince Aug 1, 2022 Accepting new patients
Sound Pain Alliance Current Accepting new patients
Proliance Surgeons Inc P S CurrentSince Aug 1, 2016 Accepting new patients
Anesis Bel-Red ASC, LLC CurrentSince Jun 25, 2024 Accepting new patients
Sound Pain Alliance Past Accepting new patients
Lake Washington Private Medicine Inc Past Accepting new patients

Locations

1260 116th Ave NE
Ste 110
Bellevue, WA 98004
Phone (425) 455-7225

4029 Northwest Ave
Ste 301
Bellingham, WA 98226
Phone (360) 526-8685

7320 216th St SW
Ste 140
Edmonds, WA 98026
Phone (425) 673-3750

7320 216th St SW
Ste 320
Edmonds, WA 98026
Phone (425) 673-3900

6808 220th St SW
Ste 201
Mountlake Terrace, WA 98043
Phone (360) 839-6778

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

629 Avenue D
Ste 1
Snohomish, WA 98290
Phone (360) 568-1554

7200 S 180th St
Ste 102
Tukwila, WA 98188

6101 Summitview Ave
Ste 200
Yakima, WA 98908
Phone (509) 902-8856

Interoperability endpoints

  • Direct secure messaging: geoffrey.tyson.p24@direct.proliance.nextgenshare.com
  • Direct secure messaging: gtyson1710416@wm.providencedirect.org
  • Direct secure messaging: geoffrey.tyson.p25@direct.proliance.nextgenshare.com

Organizations & group practices 9

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.

Hospital & facility affiliations 2

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": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1679610778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6808 220TH ST SW STE 201",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980432187",
            "telephone_number": "360-839-6778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6808 220TH ST SW STE 201",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980432187",
            "telephone_number": "360-839-6778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TYSON",
        "first_name": "GEOFFREY",
        "middle_name": "LOUIS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "MD00021183",
            "primary": false
        },
        {
            "code": "207LA0401X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Addiction Medicine",
            "state": "WA",
            "license": "MD00021183",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "WA",
            "license": "MD00021183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00184334",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountlake Terrace, WA

Sources for this page

Verify at the official NPI Registry.