Active NPI
Urology Associates, LTD., P.S.
- Urology Physician
- Olympia, WA
National Provider Identifier
1699701292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- MD00019049
- Legal business name
- UROLOGY ASSOCIATES, LTD., P.S.
- Practice address
- 3525 Ensign Rd NE
Suite a
Olympia, WA 98506-5065 - Phone
- (360) 456-4666
- Fax
- (360) 459-1566
- NPI assigned
- Jun 24, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Mark S Peckler, M.D..
- Title
- President
- Phone
- (360) 456-4666
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | MD00019049 | WA | Primary |
Addresses
Primary practice location
3525 Ensign Rd NE
Suite a
Olympia, WA 98506-5065
Mailing address
3525 Ensign Rd NE
Suite a
Olympia, WA 98506-5065
Phone (360) 456-4666
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 54181 | Other | WA | LABOR AND INDUSTRY |
| CS0195 | Other | WA | RAILROAD MEDICARE |
| 7744006 | Medicaid | WA | |
| T00395 | Other | WA | REGENCE |
National Provider Directory
National Provider DirectoryLocations
3525 Ensign Rd NE
Ste A
Olympia, WA 98506
Phone (206) 895-1825
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Physician Assistant
- Santa Barbara, CA
- NPI 1063447704
-
- Urology Physician
- Fargo, ND
- NPI 1447288261
-
- Urology Physician
- Provo, UT
- NPI 1043240989
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151107200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1226448000000",
"number": "1699701292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3525 ENSIGN RD NE",
"address_2": "SUITE A",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985065065",
"telephone_number": "360-456-4666",
"fax_number": "360-459-1566"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3525 ENSIGN RD NE",
"address_2": "SUITE A",
"city": "OLYMPIA",
"state": "WA",
"postal_code": "985065065",
"telephone_number": "360-456-4666",
"fax_number": "360-459-1566"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "UROLOGY ASSOCIATES, LTD., P.S.",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-24",
"last_updated": "2008-11-12",
"status": "A",
"authorized_official_last_name": "PECKLER",
"authorized_official_first_name": "MARK",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "360-456-4666",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D.."
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Urology",
"state": "WA",
"license": "MD00019049",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR AND INDUSTRY",
"identifier": "54181",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CS0195",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7744006",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE",
"identifier": "T00395",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Olympia, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.