Individual provider Active NPI

Paul T. Maginnis, PA-C

  • Surgical Physician Assistant
  • Bellevue, WA
National Provider Identifier
1730257585
Registry record updated May 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA60229732 Issued in WA
Practice address
1231 116TH Ave NE
Suite 750
Bellevue, WA 98004-3804
Phone
(425) 455-3600
Fax
(425) 455-3920
NPI assigned
Dec 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2012

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 MA051296 PA
Surgical Physician Assistant 363AS0400X PA60229732 WA Primary

Addresses

Primary practice location

1231 116TH Ave NE
Suite 750
Bellevue, WA 98004-3804

Mailing address

805 Madison St
Suite 901
Seattle, WA 98104-1172
Phone (206) 264-8100

Other identifiers 4

IdentifierTypeStateIssuer
G8901450OtherWAMEDICARE POSM
0281420OtherWAL & I
G8901451OtherWAMEDICARE EMRI
P01019499OtherWAMEDICARE RR KING CO.

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
I20110825000784 WA Practitioner - Physician Assistant 4385623156 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
007643NYMDMassage Therapist
PA60229732WAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons, Inc., P.S. CurrentSince Jul 11, 2011 Accepting new patients
Proliance Surgeons Inc P S Surgical CurrentSince Jul 11, 2011 Accepting new patients

Locations

1231 116th Ave NE
Ste 750
Bellevue, WA 98004
Phone (425) 455-3600

510 8th Ave NE
Ste 200
Issaquah, WA 98029
Phone (425) 392-3030

510 8th Ave NE
Ste 320
Issaquah, WA 98029

12911 120th Ave NE
Ste H120
Kirkland, WA 98034
Phone (425) 823-4226

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337040000000",
    "number": "1730257585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 MADISON ST",
            "address_2": "SUITE 901",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041172",
            "telephone_number": "206-264-8100",
            "fax_number": "206-264-8689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 116TH AVE NE",
            "address_2": "SUITE 750",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043804",
            "telephone_number": "425-455-3600",
            "fax_number": "425-455-3920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGINNIS",
        "first_name": "PAUL",
        "middle_name": "T.",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2012-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA051296",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA60229732",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE POSM",
            "identifier": "G8901450",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "0281420",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE EMRI",
            "identifier": "G8901451",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR KING CO.",
            "identifier": "P01019499",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.