NPIMap

Organization Active NPI

Oak Harbor Primary Care PLLC

Doing business as North Island Medical

  • Primary Care Clinic/Center
  • Oak Harbor, WA
National Provider Identifier
1881021905
Registry record updated Oct 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
201232264714 Issued in WA
Legal business name
OAK HARBOR PRIMARY CARE PLLC
Doing business as
North Island Medical
Practice address
135 South East Ely St.
Oak Harbor, WA 98277-9031
Phone
(360) 682-5444
Fax
(360) 682-5639
NPI assigned
Oct 3, 2013
Last updated
Oct 3, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2013

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

Authorized official

Name
Dr. Mark Richard Duncan, M.D.NPI 1598713919
Title
Partner
Phone
(360) 929-4936

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 201232264714 WA Primary

Addresses

Primary practice location

135 South East Ely St.
Oak Harbor, WA 98277-9031

Mailing address

135 SE Ely St.
Oak Harbor, WA 98277-9031
Phone (360) 682-5444

Other names 1

  • North Island Medical Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140212000119 WA Part B Supplier - Clinic/Group Practice 7517196637 Receives reassigned benefits from 13 practitioners
Practice locations: Oak Harbor, WA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1380758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380758400000",
    "number": "1881021905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 SE ELY ST.",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982779031",
            "telephone_number": "360-682-5444",
            "fax_number": "360-682-5639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 SOUTH EAST ELY ST.",
            "city": "OAK HARBOR",
            "state": "WA",
            "postal_code": "982779031",
            "telephone_number": "360-682-5444",
            "fax_number": "360-682-5639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK HARBOR PRIMARY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-03",
        "last_updated": "2013-10-03",
        "status": "A",
        "authorized_official_last_name": "DUNCAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "360-929-4936",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "WA",
            "license": "201232264714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Island Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oak Harbor, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2013; 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.