NPIMap

Organization Active NPI

Advanced Anesthesia Services, PLLC

  • Certified Registered Nurse Anesthetist
  • Bellevue, WA
National Provider Identifier
1700211786
Registry record updated Sep 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP30006926 Issued in WA
Legal business name
ADVANCED ANESTHESIA SERVICES, PLLC
Practice address
1260 116TH Ave NE Ste 110
Bellevue, WA 98004-3800
Phone
(206) 330-6722
Fax
(425) 256-3250
NPI assigned
Sep 9, 2013
Last updated
Sep 9, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2021

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

Authorized official

Name
Allyn D. Wilcock, CRNANPI 1801858535
Title
Owner
Phone
(425) 615-6100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse AnesthetistGroup: 193400000X SINGLE SPECIALTY GROUP 367500000X AP30006926 WA Primary

Addresses

Primary practice location

1260 116TH Ave NE Ste 110
Bellevue, WA 98004-3800

Mailing address

35302 SE Center St
Snoqualmie, WA 98065-9216
Phone (425) 615-6100

Other practice location 1

450 NW Gilman Blvd Ste 303
Issaquah, WA 98027-2483
Phone (425) 615-6100

Other practice location 2

155 Lilly Rd NE Ste B
Olympia, WA 98506-5028
Phone (425) 615-6100

Other practice location 3

1145 Broadway
Seattle, WA 98122-4201
Phone (425) 615-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170209001384 WA Part B Supplier - Clinic/Group Practice 6608159017 Receives reassigned benefits from 54 practitioners
Practice locations: Bellingham, WA; Tumwater, WA; Seattle, WA; Renton, WA; Puyallup, WA; Issaquah, WA; Everett, WA

National Provider Directory

National Provider Directory

Locations

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

3100 Carillon Pt
Kirkland, WA 98033
Phone (425) 576-1700

17930 Talbot Rd S
Renton, WA 98055
Phone (425) 228-3187

Practitioners & affiliated clinicians

Practitioners 57

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 57

NPI Registry JSON

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

{
    "created_epoch": "1378684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631145600000",
    "number": "1700211786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35302 SE CENTER ST",
            "city": "SNOQUALMIE",
            "state": "WA",
            "postal_code": "980659216",
            "telephone_number": "425-615-6100",
            "fax_number": "425-256-3250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 116TH AVE NE STE 110",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043800",
            "telephone_number": "206-330-6722",
            "fax_number": "425-256-3250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 NW Gilman Blvd Ste 303",
            "address_purpose": "LOCATION",
            "city": "Issaquah",
            "state": "WA",
            "postal_code": "980272483",
            "country_code": "US",
            "telephone_number": "425-615-6100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "155 Lilly Rd NE Ste B",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985065028",
            "country_code": "US",
            "telephone_number": "425-615-6100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1145 Broadway",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981224201",
            "country_code": "US",
            "telephone_number": "425-615-6100",
            "fax_number": "425-256-3250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADVANCED ANESTHESIA SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-09",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A",
        "authorized_official_last_name": "WILCOCK",
        "authorized_official_first_name": "ALLYN",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-615-6100",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WA",
            "license": "AP30006926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; 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.