Individual provider Active NPI

Eric Ebaugh, DO

  • Surgery Physician
  • Moses Lake, WA
National Provider Identifier
1750676490
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
OP60646987 Issued in WA
Practice address
840 E Hill Ave
Moses Lake, WA 98837-2238
Phone
(509) 663-8711
NPI assigned
Jun 10, 2011
Last updated
Jun 15, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X OP60646987 WA Primary
Surgery Physician 208600000X 94-07682 KS

Addresses

Primary practice location

840 E Hill Ave
Moses Lake, WA 98837-2238

Mailing address

840 E Hill Ave
Moses Lake, WA 98837-2238
Phone (509) 663-8711

Other identifiers 2

IdentifierTypeStateIssuer
1750676490MedicaidWA
P01665989OtherWARR PTAN WVH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address eebaugh23592@edirect.chehr.org
FHIR URL https://epicproxy.et0764.epichosted.com/FHIRProxy/api/FHIR/R4/

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160620001214 WA Practitioner - General Surgery 7911204243 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Kansas School of Med (KC/Wich/Sal), 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Okanogan Douglas County Hospital Dist 1Group PAC ID 7810882792, shared by 4 NPIs, 34 clinicians

Practice addresses (Care Compare)

415 Hospital Way
Brewster, WA 98812-0577
Phone (509) 689-3749

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
94-07682KSMDSurgery Physician
OP60646987WAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Okanogan Douglas County Hospital Dist 1 CurrentSince Feb 1, 2023 Accepting new patients
Okanogan Douglas County Hospital Dist 1 CurrentSince Feb 13, 2023 Accepting new patients
Okanogan Douglas County Hospital Dist1 CurrentSince Feb 1, 2023 Accepting new patients
Wenatchee Valley Hospital CurrentSince Jun 1, 2016 Accepting new patients
Wenatchee Valley Hospital Current Accepting new patients

Locations

840 E Hill Ave
Moses Lake, WA 98837
Phone (509) 764-6400

17 S Western Ave
Tonasket, WA 98855
Phone (509) 486-2174

820 N Chelan Ave
Wenatchee, WA 98801
Phone (509) 863-4868

933 Red Apple Rd
Wenatchee, WA 98801
Phone (509) 655-6125

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1307664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1750676490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 E HILL AVE",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988372238",
            "telephone_number": "509-663-8711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 E HILL AVE",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988372238",
            "telephone_number": "509-663-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBAUGH",
        "first_name": "ERIC",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-10",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "OP60646987",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KS",
            "license": "94-07682",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750676490",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR PTAN WVH",
            "identifier": "P01665989",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eebaugh23592@edirect.chehr.org",
            "affiliation": "N",
            "address_1": "840 E Hill Ave",
            "city": "Moses Lake",
            "state": "WA",
            "country_code": "US",
            "postal_code": "988372238",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0764.epichosted.com/FHIRProxy/api/FHIR/R4/",
            "affiliation": "N",
            "address_1": "840 E Hill Ave",
            "city": "Moses Lake",
            "state": "WA",
            "country_code": "US",
            "postal_code": "988372238",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Moses Lake, WA

Sources for this page

Verify at the official NPI Registry.