Individual provider Active NPI

Patrick Russell Tutt, PA-C

  • Medical Physician Assistant
  • Enumclaw, WA
National Provider Identifier
1881112910
Registry record updated Sep 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA60797427 Issued in WA
Practice address
1455 Battersby Ave
Enumclaw, WA 98022-3634
Phone
(253) 426-6341
Fax
(253) 426-6344
NPI assigned
Sep 8, 2017
Last updated
Sep 9, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA60797427 WA
Physician Assistant 363A00000X NU
Medical Physician Assistant 363AM0700X PA60797427 WA Primary

Addresses

Primary practice location

1455 Battersby Ave
Enumclaw, WA 98022-3634

Mailing address

1455 Battersby Ave
Enumclaw, WA 98022-3634
Phone (253) 426-6341

Other identifiers 1

IdentifierTypeStateIssuer
2108963MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ptutt687270@fhsce.catholichealth.net Direct Franciscan Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20230216003024 OR Practitioner - Physician Assistant 5799026795 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PeacehealthGroup PAC ID 8527016039, 200 clinicians

Practice addresses (Care Compare)

2801 NW Mercy Dr
Suite 350
Roseburg, OR 97471-2349
Phone (541) 222-2700

3311 Riverbend Dr
Springfield, OR 97477-8800
Phone (541) 222-7218

3333 Riverbend Dr
Springfield, OR 97477-8800
Phone (541) 222-7300

3355 Riverbend Dr
Springfield, OR 97477-8800
Phone (541) 222-6113

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Current Accepting new patients
Franciscan Medical Group Physician Assistant Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ptutt573380@direct.peacehealth.org
  • Direct secure messaging: ptutt687270@fhsce.catholichealth.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1504828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1881112910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 BATTERSBY AVE",
            "city": "ENUMCLAW",
            "state": "WA",
            "postal_code": "980223634",
            "telephone_number": "253-426-6341",
            "fax_number": "253-426-6344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 BATTERSBY AVE",
            "city": "ENUMCLAW",
            "state": "WA",
            "postal_code": "980223634",
            "telephone_number": "253-426-6341",
            "fax_number": "253-426-6344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUTT",
        "first_name": "PATRICK",
        "middle_name": "RUSSELL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-08",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60797427",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA60797427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2108963",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ptutt687270@fhsce.catholichealth.net",
            "affiliation": "Y",
            "affiliationName": "Franciscan Medical Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1455 Battersby Ave",
            "city": "Enumclaw",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980223634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Enumclaw, WA

Sources for this page

Verify at the official NPI Registry.