Individual provider Active NPI

Matthew S Sisk, M.D.

  • Emergency Medicine Physician
  • Everett, WA
National Provider Identifier
1710133699
Registry record updated Jul 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD 60218160 Issued in WA
Practice address
1716 W Marine View Dr Ste C
Everett, WA 98201-2098
Phone
(425) 259-0212
Fax
(425) 259-0209
NPI assigned
Aug 12, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD 60218160 WA Primary

Addresses

Primary practice location

1716 W Marine View Dr Ste C
Everett, WA 98201-2098

Mailing address

1716 W Marine View Dr Ste C
Everett, WA 98201-2098
Phone (425) 259-0212

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
I20110804000741 WA Practitioner - Emergency Medicine 7719156967 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Rush Medical College of Rush University, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Evergreen Emergency Services PSGroup PAC ID 4981694155, 48 clinicians

Practice addresses (Care Compare)

12040 NE 128TH St
Kirkland, WA 98034-3013
Phone (425) 899-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD 60218160WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No. 2 CurrentSince Feb 1, 2022 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
King County Public Hospital District No. 2 CurrentSince Feb 1, 2022 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
North Sound Emergency Medicine PC Emergency Medicine PastSince Feb 8, 2023 Accepting new patients

Locations

1909 214th St SE
Ste 110
Bothell, WA 98021
Phone (425) 488-4988

14720 Main St NE
Ste 109
Duvall, WA 98019
Phone (425) 788-4889

12040 NE 128th St
Kirkland, WA 98034
Phone (425) 899-1000

14701 179th Ave SE
Monroe, WA 98272
Phone (360) 794-1409

8980 161st Ave NE
Redmond, WA 98052
Phone (425) 895-4810

Organizations & group practices 6

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 3

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": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311033600000",
    "number": "1710133699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 W MARINE VIEW DR STE C",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982012098",
            "telephone_number": "425-259-0212",
            "fax_number": "425-259-0209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 W MARINE VIEW DR STE C",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982012098",
            "telephone_number": "425-259-0212",
            "fax_number": "425-259-0209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SISK",
        "first_name": "MATTHEW",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-12",
        "last_updated": "2011-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD 60218160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.