Catherine Anne Delsecco, PA-C

Individual provider Active NPI Medical Physician Assistant · Mercer Island, WA

NPI 1720150105 · NPPES record last updated Feb 10, 2009

Key facts

NPI
1720150105
Entity type
Individual (NPI type 1)
Primary specialty
Medical Physician Assistant 363AM0700X
License
PA-10004561 (WA)
Practice address
8435 SE 68TH St
Suite 118
Mercer Island, WA 98040-5249
Phone
(206) 232-7546
Fax
(206) 275-0805
NPI assigned
Nov 14, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare Care Compare profile

Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sound Dermatology and Skin Surgery PLLC (3 clinicians)

Practice addresses (Care Compare)

8301 161St Ave NE
Suite 108
Redmond, WA 98052-3858
Phone (425) 485-7985

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 IDStateProvider typePAC IDDetails
I20040304000587 WA Practitioner - Physician Assistant 6204723075 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA-10004561WAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen William Doggett, M.D. PA Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X PA10004561 WA
Medical Physician Assistant 363AM0700X PA-10004561 WA Yes

Addresses

Primary practice location

8435 SE 68TH St
Suite 118
Mercer Island, WA 98040-5249

Mailing address

8435 SE 68TH St
Suite 118
Mercer Island, WA 98040-5249
Phone (206) 232-7546

Other identifiers

IdentifierTypeStateIssuer
P00274267OtherWARAILROAD MEDICARE #
US7872525OtherWAAETNA SPECIALIST PIN
8371676MedicaidWA
0039578OtherWALABOR AND INDUSTRIES #
3743DEOtherWABLUE SHIELD #

Other providers in Mercer Island, WA

All providers in Mercer Island, WA · Medical Physician Assistant in Washington

Sources for this page

Verify at the official NPI Registry.