Active NPI
Matthew Salazar Surrusco, M.D.
- Trauma Surgery Physician
- Renton, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Trauma Surgery Physician
- License
- MD60875669
- 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, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2105120 | Medicaid | WA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| MD60875669 | WA | MD | Trauma Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Multicare Health System | Current | Accepting new patients | |
| Franciscan Medical Group | Current | Accepting new patients | |
| Providence Health & Services- Washington | Current | Accepting new patients | |
| Franciscan Medical Group | Surgery | Current | Accepting new patients |
| Franciscan Medical Group | Surgery | Current | Accepting new patients |
| Multicare Health System | Current | Accepting new patients | |
| Providence Health & Services - Washington | Current | Accepting new patients | |
| Multicare Health System | Current | Accepting new patients | |
| Valley Medical Group-Renton | Surgery | Current | Accepting new patients |
| Saint Alphonsus Specialty Services Inc | Surgery | Past | 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
- msurrusco123660@direct.valleymed.org
- 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.
-
dba Franciscan Orthopedics-Silverdale
- Orthopaedic Surgery Physician
- Silverdale, WA
- NPI 1093165334
-
dba Multicare Neurological Surgery
- Neurological Surgery Physician
- Tacoma, WA
- NPI 1497766638
-
dba PMG NW Wa
- General Practice Physician
- Everett, WA
- NPI 1124270715
-
dba Harrison HealthPartners, A Part of the Franciscan Medical Group
- Internal Medicine Physician
- Bremerton, WA
- NPI 1154564649
Surgery
-
dba Auburn MultiCare Clinic
- Family Medicine Physician
- Auburn, WA
- NPI 1013969195
-
dba MultiCare Deaconess Retail Pharmacy
- Community/Retail Pharmacy
- Spokane, WA
- NPI 1396594875
-
dba PMG NW WA MC Pediatrics
- Pediatrics Physician
- Everett, WA
- NPI 1437300829
-
dba St Joseph Medical Center
- General Acute Care Hospital
- Tacoma, WA
- NPI 1952309098
-
- Trauma Surgery Physician
- Boise, ID
- NPI 1093040479
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba St Joseph Lab PAC LAB
- Clinical Medical Laboratory
- Tacoma, WA
- NPI 1659585370
Hospital
-
dba St Joseph Medical Center
- General Acute Care Hospital
- Tacoma, WA
- NPI 1952309098
-
dba St Joseph Medical Center
- General Acute Care Hospital
- Tacoma, WA
- NPI 1124291117
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.