NPIMap

Organization Active NPI

Boxbar Consulting PLLC

Doing business as BoxBar Vascular

  • Vascular Surgery Physician
  • Seattle, WA
National Provider Identifier
1841712072
Registry record updated Sep 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
BOXBAR CONSULTING PLLC
Doing business as
BoxBar Vascular
Practice address
3216 NE 45TH PL Ste 207
Seattle, WA 98105-4028
Phone
(206) 596-3976
Fax
(206) 486-9013
NPI assigned
Jul 10, 2017
Last updated
Sep 14, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2017

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

Authorized official

Name
Dr. Ellen Derrick, MDNPI 1659480630
Title
Owner
Phone
(206) 596-3976

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X NU
Vascular Surgery Physician 2086S0129X NU Primary

Addresses

Primary practice location

3216 NE 45TH PL Ste 207
Seattle, WA 98105-4028

Mailing address

3216 NE 45TH Place
Suite 207
Seattle, WA 98105
Phone (206) 596-3976

Other names 1

  • BoxBar Vascular Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171103001443 WA Part B Supplier - Clinic/Group Practice 7315203528 Practice locations: Seattle, WA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1499644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505347200000",
    "number": "1841712072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3216 NE 45TH PLACE",
            "address_2": "SUITE 207",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98105",
            "telephone_number": "206-596-3976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3216 NE 45TH PL STE 207",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981054028",
            "telephone_number": "206-596-3976",
            "fax_number": "206-486-9013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOXBAR CONSULTING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-10",
        "last_updated": "2017-09-14",
        "status": "A",
        "authorized_official_last_name": "DERRICK",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-596-3976",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BoxBar Vascular",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BoxBar Vascular",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2017; 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.