Proliance Surgeons Inc., P.S.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

PROLIANCE SURGEONS INC., P.S.

Practice address

1412 SW 43Rd St
Suite 201
Renton, WA 98055-4801

Phone

(425) 228-6076

Fax

(425) 226-5224

NPI assigned

Jun 14, 2006

Organization subpart

No

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

Authorized official

Name

Mr. David G Fitzgerald

Title

Ceo

Phone

(206) 838-2599

Specialties & licenses 1

Addresses

Other names 1

• Surgical Specialists Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699718973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 OLIVE WAY",
            "address_2": "SUITE 1505",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011878",
            "telephone_number": "206-838-2590",
            "fax_number": "206-264-8689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 SW 43RD ST",
            "address_2": "SUITE 201",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980554801",
            "telephone_number": "425-228-6076",
            "fax_number": "425-226-5224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROLIANCE SURGEONS INC., P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "206-838-2599",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Surgical Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Progressive Psychological Behavioral Health Services, LLC
• Proliance Surgeons Inc P S
• Proliance Surgeons Inc P S
• Proliance Surgeons Inc P S
• Proliance Surgeons Inc PS
• Proliance Surgeons, Inc., P.S.
• Proliance Surgeons, Inc., P.S.
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• Proliance Surgery Center at Valley, LLC
• Robert F Prongay, MD

• Surgery Physician in Renton, WA
• Providers in Renton, WA by specialty
• Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.