NPIMap

Individual provider Active NPI

Brent G Thiel, MD

  • Orthopaedic Surgery Physician
  • Everett, WA
National Provider Identifier
1811093958
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
42333 Issued in WA
Practice address
3726 Broadway
Ste 201
Everett, WA 98201-3788
Phone
(425) 317-9119
Fax
(425) 317-9118
NPI assigned
Sep 16, 2006
Last updated
Jul 26, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 42333 WA Primary

Addresses

Primary practice location

3726 Broadway
Ste 201
Everett, WA 98201-3788

Mailing address

3726 Broadway
Ste 201
Everett, WA 98201-3788
Phone (425) 317-9119

Other identifiers 1

IdentifierTypeStateIssuer
1019547MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060220000390 WA Practitioner - Orthopedic Surgery 4688689102 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Medical College of Wisconsin, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3726 Broadway
Suite 201
Everett, WA 98201-3788
Phone (425) 317-9119

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement25
Lower limb (leg) arthroscopy (minimally invasive joint repair)12
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
42333WAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Care Washington PLLC CurrentSince Sep 15, 2003 Accepting new patients
Western Washington Medical Group, Inc PS Orthopaedic Surgery CurrentSince Jul 19, 2021 Accepting new patients
Western Washington Medical Group, Inc PS Current Accepting new patients
Western Washington Medical Group, Inc PS CurrentSince Jul 19, 2021 Accepting new patients
Optum Care Washington PLLC CurrentSince Sep 15, 2003 Accepting new patients
Western Washington Medical Group, Inc PS Orthopaedic Surgery Past Accepting new patients

Locations

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

1728 W Marine View Dr
Ste 111
Everett, WA 98201

3726 Broadway
Ste 201
Everett, WA 98201
Phone (425) 317-9119

3927 Rucker Ave
Everett, WA 98201
Phone (425) 339-5419

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

Interoperability endpoints

  • Direct secure messaging: bthiel726877@direct.multicare.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627257600000",
    "number": "1811093958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3726 BROADWAY",
            "address_2": "STE 201",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013788",
            "telephone_number": "425-317-9119",
            "fax_number": "425-317-9118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3726 BROADWAY",
            "address_2": "STE 201",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013788",
            "telephone_number": "425-317-9119",
            "fax_number": "425-317-9118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIEL",
        "first_name": "BRENT",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WA",
            "license": "42333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1019547",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.