Individual provider Active NPI

Matthew Salazar Surrusco, M.D.

  • Trauma Surgery Physician
  • Renton, WA
National Provider Identifier
1841559820
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
MD60875669 Issued in WA
Practice address
4033 Talbot Rd S Ste 530
Renton, WA 98055-5700
Phone
(425) 690-3433
Fax
(254) 690-9433
NPI assigned
May 10, 2012
Last updated
Oct 28, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD60875669 WA
Surgical Critical Care Physician 2086S0102X MC-2774 ID
Trauma Surgery Physician 2086S0127X MD60875669 WA Primary

Addresses

Primary practice location

4033 Talbot Rd S Ste 530
Renton, WA 98055-5700

Mailing address

4033 Talbot Rd S Ste 530
Renton, WA 98055-5700
Phone (425) 690-3433

Other practice location 1

1321 Colby Ave
Everett, WA 98201-1665
Phone (425) 261-2000

Other practice location 2

999 N Curtis Rd Ste 415
Boise, ID 83706-1334
Phone (208) 302-2600

Other identifiers 1

IdentifierTypeStateIssuer
2105120MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address msurrusco952646@wm.providencedirect.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181005001104 WA Practitioner - General Surgery 2163798604 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of North Carolina at Chapel Hill School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

1802 Yakima Ave
Suite 104
Tacoma, WA 98405-5303
Phone (253) 426-6739

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60875669WAMDTrauma Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Mar 26, 2024 Accepting new patients
Franciscan Medical Group Current Accepting new patients
Providence Health & Services- Washington CurrentSince Aug 27, 2018 Accepting new patients
Franciscan Medical Group Surgery CurrentSince Jan 1, 2025 Accepting new patients
Franciscan Medical Group Surgery CurrentSince Jan 1, 2025 Accepting new patients
Multicare Health System CurrentSince Mar 26, 2024 Accepting new patients
Providence Health & Services - Washington CurrentSince Aug 27, 2018 Accepting new patients
Multicare Health System Current Accepting new patients
Valley Medical Group-Renton Surgery CurrentSince Oct 1, 2024 Accepting new patients
Saint Alphonsus Specialty Services Inc Surgery PastSince Apr 1, 2024 Accepting new patients
Commonspirit Washington Past Accepting new patients

Locations

16850 SE 272nd St
Ste 100
Covington, WA 98042
Phone (253) 395-1971

1321 Colby Ave
Everett, WA 98201
Phone (425) 259-4413

1321 Colby Ave
Ste 2A
Everett, WA 98201
Phone (425) 404-8227

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330

3600 Lind Ave SW
Ste 100
Renton, WA 98057

4033 Talbot Rd S
Ste 430
Renton, WA 98055
Phone (425) 227-0231

4033 Talbot Rd S
Ste 530
Renton, WA 98055
Phone (425) 228-6076

1802 Yakima Ave
Ste 104
Tacoma, WA 98405
Phone (253) 426-6272

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

315 S K St
Tacoma, WA 98405
Phone (253) 403-1291

317 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 403-1400

Interoperability endpoints

  • Direct secure messaging: msurrusco123660@direct.valleymed.org
  • Direct secure messaging: msurrusco952646@wm.providencedirect.org

Organizations & group practices 11

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 3

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": "1336608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1841559820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4033 TALBOT RD S STE 530",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555700",
            "telephone_number": "425-690-3433",
            "fax_number": "254-690-9433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4033 TALBOT RD S STE 530",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555700",
            "telephone_number": "425-690-3433",
            "fax_number": "254-690-9433"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1321 Colby Ave",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982011665",
            "country_code": "US",
            "telephone_number": "425-261-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "999 N Curtis Rd Ste 415",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837061334",
            "country_code": "US",
            "telephone_number": "208-302-2600",
            "fax_number": "208-302-2625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SURRUSCO",
        "first_name": "MATTHEW",
        "middle_name": "SALAZAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-10",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD60875669",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "ID",
            "license": "MC-2774",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "WA",
            "license": "MD60875669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2105120",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msurrusco952646@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "1321 Colby Ave Ste 2A",
            "city": "Everett",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982011665",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.