NPIMap

Organization Active NPI

Heart Central of Washington, PLLC

  • Cardiovascular Disease Physician
  • Yakima, WA
National Provider Identifier
1790382224
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
HEART CENTRAL OF WASHINGTON, PLLC
Practice address
1006 S 64TH Ave Ste 110
Yakima, WA 98908-2090
Phone
(509) 902-3625
Fax
(509) 676-3415
NPI assigned
Oct 7, 2020
Last updated
Sep 23, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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

Authorized official

Name
Dr. David W Krueger, MDNPI 1235282302
Title
Owner
Phone
(509) 902-3625

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU
Cardiovascular Disease Physician 207RC0000X NU Primary

Addresses

Primary practice location

1006 S 64TH Ave Ste 110
Yakima, WA 98908-2090

Mailing address

1006 S 64TH Ave Ste 110
Yakima, WA 98908-2090
Phone (509) 902-3625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210119000311 WA Part B Supplier - Clinic/Group Practice 1557774254 Receives reassigned benefits from 5 practitioners
Practice locations: Yakima, WA

National Provider Directory

National Provider Directory

Locations

1006 S 64th Ave
Ste 110
Yakima, WA 98908
Phone (509) 902-3625

Practitioners & affiliated clinicians

Practitioners 5

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": "1602028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632355200000",
    "number": "1790382224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 S 64TH AVE STE 110",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989082090",
            "telephone_number": "509-902-3625",
            "fax_number": "509-676-3415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 S 64TH AVE STE 110",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989082090",
            "telephone_number": "509-902-3625",
            "fax_number": "509-676-3415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART CENTRAL OF WASHINGTON, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-07",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A",
        "authorized_official_last_name": "KRUEGER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-902-3625",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; 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.