Individual provider Active NPI

Todd Ewert, MD

  • Emergency Medicine Physician
  • Spokane, WA
National Provider Identifier
1861471385
Registry record updated Nov 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
00047007 Issued in WA
Practice address
5633 N Lidgerwood St
Spokane, WA 99208-1224
Phone
(509) 482-2448
NPI assigned
Jan 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 00047007 WA Primary

Addresses

Primary practice location

5633 N Lidgerwood St
Spokane, WA 99208-1224

Mailing address

5633 N Lidgerwood St
Spokane, WA 99208-1224
Phone (509) 482-2448

Other identifiers 2

IdentifierTypeStateIssuer
8910181MedicaidNC
N01604MedicaidSC

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
I20070213000128 WA Practitioner - Emergency Medicine 1254232002 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Rush Medical College of Rush University, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services WashingtonGroup PAC ID 0345139929, 778 clinicians

Practice addresses (Care Compare)

16528 E Desmet CT
Suite B2100
Spokane Valley, WA 99216-3522
Phone (509) 944-9440

Hospital & facility affiliations

  • Prov Sacred HRT Med Ctr & Childs Hosp. Hospital, Spokane, WA, CCN 500054

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00047007WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince Nov 2, 2019 Accepting new patients
Providence Health & Services - Washington Past Accepting new patients
Piedmont Emergency Medical Associates, PA Emergency Medicine Past Accepting new patients
Providence Health & Services - Washington Past Accepting new patients

Locations

1200 W Fairview St
Colfax, WA 99111
Phone (509) 397-3435

1200 E Columbia Ave
Colville, WA 99114
Phone (509) 684-3701

714 W Pine St
Newport, WA 99156
Phone (509) 447-2441

5633 N Lidgerwood St
Spokane, WA 99208
Phone (509) 482-0111

910 N Washington St
Ste 209
Spokane, WA 99201
Phone (509) 232-1192

910 N Washington St
Spokane, WA 99201
Phone (509) 327-9831

16528 E Desmet Ct
Ste B2100
Spokane Valley, WA 99216
Phone (509) 944-8840

16528 E Desmet Ct
Ste A1200
Spokane Valley, WA 99216
Phone (509) 489-8910

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.

Hospital & facility affiliations 1

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": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574812800000",
    "number": "1861471385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5633 N LIDGERWOOD ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992081224",
            "telephone_number": "509-482-2448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5633 N LIDGERWOOD ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992081224",
            "telephone_number": "509-482-2448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EWERT",
        "first_name": "TODD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2019-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "00047007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8910181",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N01604",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.