NPIMap

Individual provider Active NPI

Paul Hrissikopoulos, MD

  • Anesthesiology Physician
  • Bremerton, WA
National Provider Identifier
1881756765
Registry record updated May 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD00020630 Issued in WA
Practice address
2025 Wheaton Way
Suite 102
Bremerton, WA 98310-4300
Phone
(360) 479-0809
Fax
(360) 377-3577
NPI assigned
Dec 15, 2006
Last updated
May 27, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD00020630 WA Primary

Addresses

Primary practice location

2025 Wheaton Way
Suite 102
Bremerton, WA 98310-4300

Mailing address

2025 Wheaton Way
Suite 102
Bremerton, WA 98310-4300
Phone (360) 479-0809

Other identifiers 8

IdentifierTypeStateIssuer
1030105MedicaidWA
192575000OtherWAOWCP
911577098OtherWAUNIFORM MEDICAL PLAN
HR8307OtherWAREGENCE
38300OtherWALABOR AND INDUSTRIES
911577098OtherWAPREMERA BLUE CROSS
911577098-02OtherWAKITSAP PHYSICIANS SERVICE
013194010OtherWAGROUP HEALTH COOPERATIVE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00020630WAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Anesthesiologists of Kitsap Co Anesthesiology Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211846400000",
    "number": "1881756765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2025 WHEATON WAY",
            "address_2": "SUITE 102",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983104300",
            "telephone_number": "360-479-0809",
            "fax_number": "360-377-3577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2025 WHEATON WAY",
            "address_2": "SUITE 102",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983104300",
            "telephone_number": "360-479-0809",
            "fax_number": "360-377-3577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HRISSIKOPOULOS",
        "first_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2008-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "MD00020630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1030105",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "192575000",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIFORM MEDICAL PLAN",
            "identifier": "911577098",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "HR8307",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "38300",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMERA BLUE CROSS",
            "identifier": "911577098",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KITSAP PHYSICIANS SERVICE",
            "identifier": "911577098-02",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP HEALTH COOPERATIVE",
            "identifier": "013194010",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.