Individual provider Active NPI

Carolyn Saylor Hawk, MD, PHD

  • Pediatrics Physician
  • Marysville, WA
National Provider Identifier
1841599099
Registry record updated Nov 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD 60478623 Issued in WA
Practice address
2901 174TH St NE
Marysville, WA 98271-4743
Phone
(360) 454-1900
Fax
(360) 454-1991
NPI assigned
Mar 26, 2011
Last updated
Nov 5, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Pediatrics Physician 208000000X ML60224589 WA
Pediatrics Physician 208000000X MD 60478623 WA Primary

Addresses

Primary practice location

2901 174TH St NE
Marysville, WA 98271-4743

Mailing address

PO Box 5127
Everett, WA 98206-5127
Phone (425) 258-3900

Other identifiers 1

IdentifierTypeStateIssuer
2019010MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, NM2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20151001002369 WA Practitioner - Pediatric Medicine 5193033637 Reassigns benefits to 1 organization
I20230131003538 NM Practitioner - Pediatric Medicine 5193033637 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD 60478623WAMDPediatrics Physician
ML60224589WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services Pediatrics CurrentSince Feb 14, 2023 Accepting new patients
Optum Care Washington PLLC Pediatrics CurrentSince Sep 21, 2015 Accepting new patients
Presbyterian Healthcare Services CurrentSince Feb 14, 2023 Accepting new patients
Optum Care Washington PLLC Pediatrics CurrentSince Sep 21, 2015 Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients

Locations

401 San Mateo Blvd SE
Albuquerque, NM 87108
Phone (505) 462-7333

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

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

2901 174th St NE
Marysville, WA 98271
Phone (360) 454-1900

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

Interoperability endpoints

  • Direct secure messaging: chawk224344@direct.phs.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1301097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446681600000",
    "number": "1841599099",
    "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": "425-258-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 174TH ST NE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982714743",
            "telephone_number": "360-454-1900",
            "fax_number": "360-454-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWK",
        "first_name": "CAROLYN",
        "middle_name": "SAYLOR",
        "credential": "MD, PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-26",
        "last_updated": "2015-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "ML60224589",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD 60478623",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2019010",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marysville, WA

Sources for this page

Verify at the official NPI Registry.