Organization Active NPI

Urology Associates, LTD., P.S.

  • Urology Physician
  • Olympia, WA
National Provider Identifier
1699701292
Registry record updated Nov 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD00019049 Issued in WA
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

Updated by the provider on Nov 12, 2008

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)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
54181OtherWALABOR AND INDUSTRY
CS0195OtherWARAILROAD MEDICARE
7744006MedicaidWA
T00395OtherWAREGENCE

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.