Micky Patrick Cates, PA-C
Individual provider Active NPI Physician Assistant · University Place, WA
NPI 1770001133 · NPPES record last updated Oct 17, 2018
Key facts
- NPI
- 1770001133
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 60900958 (WA)
- Practice address
- 1924 70TH Ave West
Apt E5
University Place, WA 98466 - Phone
- (541) 980-9175
- NPI assigned
- Sep 6, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 5
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Klickitat County Public Hospital District No 1
Practice addresses (Care Compare)
317 Sanders Way
Goldendale, WA 98620-9059
Phone (509) 773-4017
Hospital & facility affiliations
- Klickitat Valley Hospital
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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191024002401 | WA | Practitioner - Physician Assistant | 0547500084 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60900958 | WA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Klickitat County Public Hospital District No 1 | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | |||
| Physician Assistant | 363A00000X | 60900958 | WA | Yes |
Addresses
Primary practice location
1924 70TH Ave West
Apt E5
University Place, WA 98466
Mailing address
709 W 10TH St
The Dalles, OR 97058-1468
Phone (541) 980-9175
Other providers in University Place, WA
- Ariel Carmichael
- Candace Carpenter
- Osman O Carrim
- Amberly Carter-Curl
- Carrie Casey
- Catholic Community Services of Western Washington
- Wes Cauthers
- Leah Ceehorne
- Brynn Cenicola
- Calypso Cervantes
All providers in University Place, WA · Physician Assistant in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.