Sunnyside Family Medicine, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OP00001175 Issued in WA

Legal business name

SUNNYSIDE FAMILY MEDICINE, PC

Practice address

2240 E Lincoln Ave
Sunnyside, WA 98944-2487

Phone

(509) 837-6681

Fax

(509) 839-0075

NPI assigned

Mar 13, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Olga Medelez

Title

Reception/Billing

Phone

(509) 837-6681

Specialties & licenses 1

Addresses

Other identifiers 9

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/3721/brand/1/csg/1/fhir/r4

Practitioners 5

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

• Gregory B Bickel, PA-C

  • Physician Assistant
  • Yakima, WA
  • NPI 1982763785
  NPD (past)
• Sophie Gomez, M.D.

  • Sleep Medicine (Internal Medicine) Physician
  • Kennewick, WA
  • NPI 1497725998
  NPD (past)
• Sandra M Kron, ARNP

  • Family Nurse Practitioner
  • Sunnyside, WA
  • NPI 1639229610
  NPD (past)
• Constancio Concepcion, MD

  • Pediatrics Physician
  • Austin, TX
  • NPI 1770574659
  NPD (past)
• Kavitha Vani Manjunath, M.D

  • Family Medicine Physician
  • Johnstown, PA
  • NPI 1992847768

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481241600000",
    "number": "1780717207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 E LINCOLN AVE",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989442487",
            "telephone_number": "509-837-6681",
            "fax_number": "509-839-0075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 E LINCOLN AVE",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989442487",
            "telephone_number": "509-837-6681",
            "fax_number": "509-839-0075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNNYSIDE FAMILY MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2016-12-09",
        "status": "A",
        "authorized_official_last_name": "MEDELEZ",
        "authorized_official_first_name": "OLGA",
        "authorized_official_title_or_position": "RECEPTION/BILLING",
        "authorized_official_telephone_number": "509-837-6681",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP00001175",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS NUMBER",
            "identifier": "8935331",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I NUMBER",
            "identifier": "0146394",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9616897",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I NUMBER",
            "identifier": "0052792",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1057496",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7081540",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8264582",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I NUMBER",
            "identifier": "0146393",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I GROUP NUMBER",
            "identifier": "112305",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sunnyside Community Hospital Association
• Sunnyside Community Hospital Association
• Sunnyside Community Hospital Association
• Sunnyside Community Hospital Home Medical Supply LLC
• Sunnyside Emergency Group a Professional LLC
• Sunnyside Family Practice PLLC
• Sunnyside Home Health
• Sunnyside Physical & Sports Therapy
• Sunnyside SNF Healthcare LLC
• Sunnyside Vision PLLC

• All providers in Sunnyside, WA
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2016; 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.