NPIMap

Organization Active NPI

Kittitas County Public Hospital Dist 1

Doing business as KVH General Surgery

  • Specialist
  • Ellensburg, WA
National Provider Identifier
1790910057
Registry record updated Jul 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
000036 Issued in WA
Legal business name
KITTITAS COUNTY PUBLIC HOSPITAL DIST 1
Doing business as
KVH General Surgery
Practice address
603 S Chestnut St
Ellensburg, WA 98926-3875
Phone
(509) 962-7390
NPI assigned
May 15, 2009
Last updated
Jul 29, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2026

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

Authorized official

Name
Lisa Gott
Title
Revenue Cycle Director Operation
Phone
(509) 962-7424

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 000036 WA Primary

Addresses

Primary practice location

603 S Chestnut St
Ellensburg, WA 98926-3875

Mailing address

PO Box 799
Ellensburg, WA 98926-1921
Phone (509) 962-7390

Other practice location 1

603 S Chestnut St
Ellensburg, WA 98926-3875
Phone (509) 933-8619

Other identifiers 1

IdentifierTypeStateIssuer
G000319179OtherWAMEDICARE PTAN

Other names 1

  • KVH General Surgery Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040213000046 WA Part B Supplier - Clinic/Group Practice 0547179608 Receives reassigned benefits from 176 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ellensburg, WA; Cle Elum, WA

Other NPIs on the same Medicare enrollment 8

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

National Provider Directory

National Provider Directory
Tax ID family
Kittitas Co Pub Hos Dis 116 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Locations

201 Alpha Way
Cle Elum, WA 98922
Phone (509) 674-5331

Interoperability endpoints

  • Direct secure messaging: to'brien@kittitasvalleyhealthcare.cernerdirect.com
  • Direct secure messaging: tpenoyar@kittitasvalleyhealthcare.cernerdirect.com

Practitioners & affiliated clinicians

Practitioners 22

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.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1242345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785283200000",
    "number": "1790910057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 799",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989261921",
            "telephone_number": "509-962-7390",
            "fax_number": "509-925-6948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 S CHESTNUT ST",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989263875",
            "telephone_number": "509-962-7390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "603 S Chestnut St",
            "address_purpose": "LOCATION",
            "city": "Ellensburg",
            "state": "WA",
            "postal_code": "989263875",
            "country_code": "US",
            "telephone_number": "509-933-8619",
            "fax_number": "509-962-7351",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KITTITAS COUNTY PUBLIC HOSPITAL DIST 1",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-15",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A",
        "authorized_official_last_name": "GOTT",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "REVENUE CYCLE DIRECTOR OPERATION",
        "authorized_official_telephone_number": "509-962-7424"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "000036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "G000319179",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KVH General Surgery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "KVH General Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ellensburg, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2026; 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.