NPIMap

Organization Active NPI

Kitsap Radiation Oncology Associates PLLC

  • Radiation Oncology Physician
  • Bremerton, WA
National Provider Identifier
1811008220
Registry record updated Feb 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
28700 Issued in WA
Legal business name
KITSAP RADIATION ONCOLOGY ASSOCIATES PLLC
Practice address
2520 Cherry Ave
Bremerton, WA 98310-4229
Phone
(512) 583-2004
Fax
(360) 475-8542
NPI assigned
Aug 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2020

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

Authorized official

Name
Dr. Stephen Charles Springate, M.D.
Title
MD Owner
Phone
(360) 475-8545

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0001X 28700 WA Primary

Addresses

Primary practice location

2520 Cherry Ave
Bremerton, WA 98310-4229

Mailing address

PO Box 84251
Seattle, WA 98124-5551
Phone (360) 744-8545

Other identifiers 1

IdentifierTypeStateIssuer
7134695MedicaidWA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581552000000",
    "number": "1811008220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 84251",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981245551",
            "telephone_number": "360-744-8545",
            "fax_number": "360-744-8542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 CHERRY AVE",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983104229",
            "telephone_number": "512-583-2004",
            "fax_number": "360-475-8542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KITSAP RADIATION ONCOLOGY ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A",
        "authorized_official_last_name": "SPRINGATE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "MD OWNER",
        "authorized_official_telephone_number": "360-475-8545",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": "WA",
            "license": "28700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7134695",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2020; 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.