Andrew C Schock, PA-C
Individual provider Active NPI Physician Assistant · Ellensburg, WA
NPI 1720001092 · NPPES record last updated Apr 30, 2013
Key facts
- NPI
- 1720001092
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 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
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 80.91 of 100
- Quality
- 66.6
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 69.77
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050315001153 | WA | Practitioner - Physician Assistant | 3870547235 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA10003463 | WA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kittitas County Public Hospital Dist 1 | Current | Accepting new patients | |
| Kittitas County Public Hospital Dist 1 | Current |
Accepting new patients | |
| Kittitas County Public Hosp Dist 1 | Current |
Accepting new patients | |
| Yakima Chest Clinic, P.C. | Past |
Accepting new patients | |
| Kittitas County Hospital Dist 2 | Past | Accepting new patients |
Locations
700 E Manitoba Ave
Ste 101
Ellensburg, WA 98926
Phone (509) 452-5378
716 E Manitoba Ave
Ellensburg, WA 98926
Phone (509) 925-3151
700 E Manitoba Ave
Ellensburg, WA 98926
Phone (509) 925-6100
603 S Chestnut St
Ellensburg, WA 98926
Phone (509) 933-8693
Interoperability endpoints
- aschock@kittitasvalleyhealthcare.cernerdirect.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA10003463 | WA | |
| Physician Assistant | 363A00000X | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8402836 | Medicaid | WA |
Other providers in Ellensburg, WA
- Ryan Robert Scheffelmaier
- Tanner Scheid
- Emily R Schmidlkofer
- Bryana Schmidt
- Paula Rae Schnebly
- Macy Ann Schorno
- Ellen D Schwannecke
- Jill D. Schwarz
- Jonathon Seaborn
- Trudie Sechrest
All providers in Ellensburg, WA · Physician Assistant in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.