Organization Active NPI

Surgery Suite Specialist, LLC.

  • Surgical Physician Assistant
  • Kirkland, WA
National Provider Identifier
1740335066
Registry record updated Aug 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA10002119 Issued in WA
Legal business name
SURGERY SUITE SPECIALIST, LLC.
Practice address
9701 NE 120TH PL
Kirkland, WA 98034-4275
Phone
(206) 909-2601
NPI assigned
Jan 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2014

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

Authorized official

Name
Jack W Romano
Title
Owner
Phone
(206) 909-2601

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X PA10002119 WA Primary

Addresses

Primary practice location

9701 NE 120TH PL
Kirkland, WA 98034-4275

Mailing address

9701 NE 120TH PL
Kirkland, WA 98034-4275
Phone (206) 909-2601

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407888000000",
    "number": "1740335066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9701 NE 120TH PL",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980344275",
            "telephone_number": "206-909-2601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9701 NE 120TH PL",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980344275",
            "telephone_number": "206-909-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGERY SUITE SPECIALIST, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2014-08-13",
        "status": "A",
        "authorized_official_last_name": "ROMANO",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-909-2601"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA10002119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.