Individual provider Active NPI

Stuart Brown, PA-C

  • Medical Physician Assistant
  • Pasco, WA
National Provider Identifier
1871283523
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA61614061 Issued in WA
Practice address
6115 Burden Blvd Ste D
Pasco, WA 99301-0010
Phone
(509) 488-5256
Fax
(509) 488-9939
NPI assigned
May 8, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA61614061 WA Primary

Addresses

Primary practice location

6115 Burden Blvd Ste D
Pasco, WA 99301-0010

Mailing address

1515 E Columbia St
Othello, WA 99344-1846
Phone (509) 488-5256

Other practice location 1

1800 Novell Pl
Provo, UT 84606-6101
Phone (801) 375-5125

Other practice location 2

1515 E Columbia St
Othello, WA 99344-1846
Phone (509) 488-5256

Other practice location 3

1051 S Columbia Avenue
Connell, WA 99326
Phone (509) 488-5256 ext. 8512

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241125000232 WA Practitioner - Physician Assistant 0547795874 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA61614061WAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rocky Mountain University of Health Professions Foundation CurrentSince Feb 4, 2024 Accepting new patients
Columbia Basin Health Association CurrentSince Oct 18, 2024 Accepting new patients
Columbia Basin Health Association Past Accepting new patients

Locations

1800 Novell Pl
Provo, UT 84606
Phone (801) 375-5125

601 Government Rd
Mattawa, WA 99349
Phone 5094885256 ext. 8512

1515 E Columbia St
Othello, WA 99344
Phone (509) 488-5250

6115 Burden Blvd
Ste D
Pasco, WA 99301
Phone 5094885256 ext. 8512

7405 Three Rivers Dr
Pasco, WA 99301
Phone 5094885256 ext. 8512

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.

NPI Registry JSON

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

{
    "created_epoch": "1683504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1871283523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 E COLUMBIA ST",
            "city": "OTHELLO",
            "state": "WA",
            "postal_code": "993441846",
            "telephone_number": "509-488-5256",
            "fax_number": "509-488-9939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6115 BURDEN BLVD STE D",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993010010",
            "telephone_number": "509-488-5256",
            "fax_number": "509-488-9939"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Novell Pl",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846066101",
            "country_code": "US",
            "telephone_number": "801-375-5125",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1515 E Columbia St",
            "address_purpose": "LOCATION",
            "city": "Othello",
            "state": "WA",
            "postal_code": "993441846",
            "country_code": "US",
            "telephone_number": "509-488-5256",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1051 S Columbia Avenue",
            "address_purpose": "LOCATION",
            "city": "Connell",
            "state": "WA",
            "postal_code": "99326",
            "country_code": "US",
            "telephone_number": "509-488-5256 x8512",
            "fax_number": "509-488-9939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "STUART",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-08",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA61614061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasco, WA

Sources for this page

Verify at the official NPI Registry.