Individual provider Active NPI

Andrew C Schock, PA-C

  • Physician Assistant
  • Ellensburg, WA
National Provider Identifier
1720001092
Registry record updated Apr 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
700 E Manitoba Ave
Suite 101
Ellensburg, WA 98926-3885
Phone
(509) 925-6100
Fax
(509) 925-7604
NPI assigned
Jul 26, 2006
Last updated
Apr 30, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA10003463 WA
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

700 E Manitoba Ave
Suite 101
Ellensburg, WA 98926-3885

Mailing address

700 E Manitoba Ave
Suite 101
Ellensburg, WA 98926-3885
Phone (509) 925-6100

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050315001153 WA Practitioner - Physician Assistant 3870547235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
80.91 of 100Reported as group
Quality
66.6
Promoting interoperability
100
Improvement activities
40
Cost
69.77

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA10003463WAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kittitas County Public Hosp Dist 1 CurrentSince Apr 1, 2010 Accepting new patients
Kittitas County Public Hospital Dist 1 Current Accepting new patients
Kittitas County Hospital Dist 2 Past Accepting new patients
Yakima Chest Clinic, P.C. PastSince Sep 1, 2014 Accepting new patients

Locations

603 S Chestnut St
Ellensburg, WA 98926
Phone (509) 933-8693

700 E Manitoba Ave
Ellensburg, WA 98926
Phone (509) 925-6100

700 E Manitoba Ave
Ste 101
Ellensburg, WA 98926
Phone (509) 452-5378

716 E Manitoba Ave
Ellensburg, WA 98926
Phone (509) 925-3151

Interoperability endpoints

  • Direct secure messaging: aschock@kittitasvalleyhealthcare.cernerdirect.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367280000000",
    "number": "1720001092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E MANITOBA AVE",
            "address_2": "SUITE 101",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989263885",
            "telephone_number": "509-925-6100",
            "fax_number": "509-925-7604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E MANITOBA AVE",
            "address_2": "SUITE 101",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989263885",
            "telephone_number": "509-925-6100",
            "fax_number": "509-925-7604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOCK",
        "first_name": "ANDREW",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2013-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10003463",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellensburg, WA

Sources for this page

Verify at the official NPI Registry.