NPIMap

Organization Active NPI

Palouse Specialty Physicians, P.S.

Doing business as Palouse ENT & Audiology

  • Otolaryngology Physician
  • Pullman, WA
National Provider Identifier
1760889265
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
PALOUSE SPECIALTY PHYSICIANS, P.S.
Doing business as
Palouse ENT & Audiology
Practice address
825 SE Bishop Blvd
Suite 601
Pullman, WA 99163-5517
Phone
(509) 334-5876
Fax
(509) 332-8793
NPI assigned
Nov 26, 2014
Last updated
Nov 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Authorized official

Name
Sacha L Smith
Title
Dir of Operations
Phone
(509) 332-3488

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Y00000X Primary
AudiologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 231H00000X

Addresses

Primary practice location

825 SE Bishop Blvd
Suite 601
Pullman, WA 99163-5517

Mailing address

PO Box 847
Pullman, WA 99163-0847
Phone (509) 332-6139

Other names 1

  • Palouse ENT & Audiology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150429001221 WA Part B Supplier - Clinic/Group Practice 0345569166 Receives reassigned benefits from 9 practitioners
Practice locations: Pullman, WA
O20150718000066 ID Part B Supplier - Clinic/Group Practice 0345569166 Receives reassigned benefits from 9 practitioners
2 other NPIs on this enrollment
Practice locations: Moscow, ID

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

Locations

803 S Main St
Ste 210
Moscow, ID 83843
Phone (208) 882-1778

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1416960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731974400000",
    "number": "1760889265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 847",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991630847",
            "telephone_number": "509-332-6139",
            "fax_number": "509-332-6579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 SE BISHOP BLVD",
            "address_2": "SUITE 601",
            "city": "PULLMAN",
            "state": "WA",
            "postal_code": "991635517",
            "telephone_number": "509-334-5876",
            "fax_number": "509-332-8793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALOUSE SPECIALTY PHYSICIANS, P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-26",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "SACHA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIR OF OPERATIONS",
        "authorized_official_telephone_number": "509-332-3488"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palouse ENT & Audiology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Palouse ENT & Audiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pullman, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.