Daniel James Kissau, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD61444250 Issued in WA

Practice address

413 Lilly Rd NE
Olympia, WA 98506-5133

Phone

(360) 493-4083

Fax

(360) 486-6436

NPI assigned

Mar 22, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Internal MedicineAlso: Hospitalist

Education

Wayne State University School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Services WashingtonGroup PAC ID 6709782600, 480 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence St Peter Hospital Hospital, Olympia, WA, CCN 500024
• Providence Centralia Hospital Hospital, Centralia, WA, CCN 500019
• Capital Medical Center Hospital, Olympia, WA, CCN 500139

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Providence Health & Services Washington

  • Family Medicine Physician
  • Olympia, WA
  • NPI 1174744304
  Medicare reassignment Care Compare group NPD
• Providence Health & Services Washington

  • General Acute Care Hospital
  • Centralia, WA
  • NPI 1376624981
  Medicare reassignment NPD
• Providence Health & Services Washington

  • General Acute Care Hospital
  • Olympia, WA
  • NPI 1619176997

  Internal Medicine

  Medicare reassignment NPD
• Providence Health & Services Washington

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Olympia, WA
  • NPI 1023550050
  NPD
• Providence Health & Services Washington

  • Rural Health Clinic/Center
  • Centralia, WA
  • NPI 1225763949

  Internal Medicine

  NPD
• Providence Health & Services Washington

  • General Acute Care Hospital
  • Centralia, WA
  • NPI 1275732661

  Internal Medicine

  NPD
• Providence Health & Services Washington

  • Radiation Oncology Clinic/Center
  • Aberdeen, WA
  • NPI 1457721250
  NPD
• Providence Health & Services Washington

  • General Acute Care Hospital
  • Olympia, WA
  • NPI 1346250594
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Multicare Health System

  • General Acute Care Hospital
  • Olympia, WA
  • NPI 1841258639
  Care Compare affiliation
• Providence Health & Services Washington

  • General Acute Care Hospital
  • Olympia, WA
  • NPI 1346250594
  Care Compare affiliation
• Providence Health & Services Washington

  • General Acute Care Hospital
  • Centralia, WA
  • NPI 1376624981
  Care Compare affiliation
• Providence Health & Services Washington

  • General Acute Care Hospital
  • Olympia, WA
  • NPI 1619176997
  Care Compare affiliation

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

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1861996837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065133",
            "telephone_number": "360-493-4083",
            "fax_number": "360-486-6436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISSAU",
        "first_name": "DANIEL",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-22",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD61444250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kirk'S Drug, Inc
• Deborah Kirkpatrick, DOULA, MIDWIFE
• Stephen Lee Kirkpatrick, D.D.S.
• Jodi R Kirkwood
• Karen Harriett Kirsch, CMA, RSMT
• Richelle Kistler, PHARMD
• W. Alexander Kistler, M.D.
• Akiko Kitada, DDS
• Makenna E Kitterman
• Saowarut Kittimongcolporn, MD

• Internal Medicine Physician in Olympia, WA
• Providers in Olympia, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.