NPIMap

Organization Active NPI

Whidbey Island Public Hospital District

Doing business as WhidbeyHealth Anesthesia

  • Anesthesiology Physician
  • Coupeville, WA
National Provider Identifier
1861897076
Registry record updated Jun 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT
Doing business as
WhidbeyHealth Anesthesia
Practice address
101 N. Main St.
Coupeville, WA 98239
Phone
(360) 678-5151
NPI assigned
Oct 30, 2014
Last updated
Jun 10, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2016

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

Authorized official

Name
Ronald L Telles
Title
Cfo
Phone
(360) 678-7656

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X

Addresses

Primary practice location

101 N. Main St.
Coupeville, WA 98239

Mailing address

PO Box 24077
Seattle, WA 98124-0077
Phone (800) 516-5315

Other identifiers 2

IdentifierTypeStateIssuer
615186800OtherWAFEDERAL WORKERS COMP
0333819OtherWAWORKERS COMP OF WA

Other names 1

  • WhidbeyHealth Anesthesia Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040210000761 WA Part B Supplier - Clinic/Group Practice 1658280680 Receives reassigned benefits from 136 practitioners
17 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory
Tax ID family
Whidbey Island Public Hospital District38 organizations share this tax ID, including this one

Other organizations with this tax ID 37

Organizations that report the same tax identification number in the National Provider Directory.

View all 37

Practitioners & affiliated clinicians

Practitioners 9

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": "1414627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465516800000",
    "number": "1861897076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24077",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981240077",
            "telephone_number": "800-516-5315",
            "fax_number": "517-787-7365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N. MAIN ST.",
            "city": "COUPEVILLE",
            "state": "WA",
            "postal_code": "98239",
            "telephone_number": "360-678-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHIDBEY ISLAND PUBLIC HOSPITAL DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-30",
        "last_updated": "2016-06-10",
        "status": "A",
        "authorized_official_last_name": "TELLES",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "360-678-7656"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL WORKERS COMP",
            "identifier": "615186800",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMP OF WA",
            "identifier": "0333819",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WhidbeyHealth Anesthesia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coupeville, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2016; 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.