Active NPI
Robert L Michaelson, MD
- Surgery Physician
- Everett, WA
National Provider Identifier
1861457038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- MD00039621
- Practice address
- 125 130TH St SE
Everett, WA 98208-6400 - Phone
- (425) 385-2263
- NPI assigned
- Apr 19, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | MD00039621 | WA | Primary |
Addresses
Primary practice location
125 130TH St SE
Everett, WA 98208-6400
Mailing address
125 130TH St SE
Suite 100
Everett, WA 98208
Phone (425) 385-2263
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jun 9, 2015 through Jun 9, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00039621 | WA | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southeast Surgical Associates, P.a. | Surgery | Past | Accepting new patients |
| Sound Weight and Wellness PLLC | Past | Accepting new patients | |
| Northwest Weight Loss Surgery, PLLC | Past | Accepting new patients | |
| Sound Surgeons PLLC | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/19317/brand/1/csg/1/fhir/r4
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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- Ambulatory Surgical Clinic/Center
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- NPI 1396123865
-
- Surgery Physician
- San Antonio, TX
- NPI 1821008939
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145404800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468368000000",
"number": "1861457038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 130TH ST SE",
"address_2": "SUITE 100",
"city": "EVERETT",
"state": "WA",
"postal_code": "98208",
"telephone_number": "425-385-2263",
"fax_number": "425-385-8476"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 130TH ST SE",
"city": "EVERETT",
"state": "WA",
"postal_code": "982086400",
"telephone_number": "425-385-2263"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHAELSON",
"first_name": "ROBERT",
"middle_name": "L",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-19",
"last_updated": "2016-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WA",
"license": "MD00039621",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Jul 13, 2016; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.