NPIMap

Organization Active NPI

Optum Care Washington PLLC

  • Multi-Specialty Clinic/Center
  • Everett, WA
National Provider Identifier
1831186766
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
OPTUM CARE WASHINGTON PLLC
Practice address
3901 Hoyt Ave
Everett, WA 98201-4918
Phone
(425) 259-0966
NPI assigned
Oct 5, 2005
Last updated
Apr 8, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
EVERETT PHYSICIANS, INC. P.S.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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

Authorized official

Name
George Go, M.D.NPI 1447353693
Title
Board President
Phone
(425) 258-3900

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 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU
Internal Medicine Physician 207R00000X NU
Pediatrics Physician 208000000X NU
Multi-Specialty Clinic/Center 261QM1300X NU Primary
Clinical Medical Laboratory 291U00000X 50D0662654 WA
Durable Medical Equipment & Medical Supplies 332B00000X NU

Addresses

Primary practice location

3901 Hoyt Ave
Everett, WA 98201-4918

Mailing address

PO Box 5127
Everett, WA 98206-5127
Phone (425) 259-0966

Other names 1

  • The Everett Clinic, PLLC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031211000922 WA Part B Supplier - Clinic/Group Practice 6406752153 Receives reassigned benefits from 1,384 practitioners
1 other NPI on this enrollment
Practice locations: Everett, WA; Mill Creek, WA; Kirkland, WA; La Conner, WA; Lake Stevens, WA; Lynnwood, WA; Marysville, WA; Mountlake Terrace, WA…
O20101208001309 WA DME Supplier - Multi-Specialty - Physician 6406752153 Practice locations: Everett, WA

Other NPIs with the same Medicare PAC ID 19

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 19

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Locations

1303 Pacific Ave
Everett, WA 98201
Phone (425) 259-6069

8910 Vernon Rd
Lake Stevens, WA 98258
Phone (425) 397-1700

3916 148th St SE
Ste 201
Mill Creek, WA 98012
Phone (425) 304-1100

4410 106th St SW
Mukilteo, WA 98275
Phone (206) 388-6000

11019 Canyon Rd E
Ste A
Puyallup, WA 98373
Phone (253) 537-0293

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

17000 140th Ave NE
Unit 101
Woodinville, WA 98072
Phone (425) 481-6363

Practitioners & affiliated clinicians

Practitioners 1,398

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 1,398

NPI Registry JSON

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712534400000",
    "number": "1831186766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5127",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982065127",
            "telephone_number": "425-259-0966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 HOYT AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014918",
            "telephone_number": "425-259-0966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTUM CARE WASHINGTON PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EVERETT PHYSICIANS, INC. P.S.",
        "enumeration_date": "2005-10-05",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A",
        "authorized_official_last_name": "GO",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "BOARD PRESIDENT",
        "authorized_official_telephone_number": "425-258-3900",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "WA",
            "license": "50D0662654",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Everett Clinic, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; 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.