Individual provider Active NPI

Brandea J Scott-Vessel, PA-C

  • Physician Assistant
  • Everett, WA
National Provider Identifier
1881774859
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10004743 Issued in WA
Practice address
1717 13TH St
Everett, WA 98201-1621
Phone
(425) 258-3900
Fax
(425) 297-5561
NPI assigned
Oct 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10004743 WA Primary

Addresses

Primary practice location

1717 13TH St
Everett, WA 98201-1621

Mailing address

PO Box 5127
Everett, WA 98206-5127
Phone (425) 258-3900

Other practice location 1

13720 41st Ave NE
Seattle, WA 98125-3821
Phone (206) 579-6379

Other identifiers 3

IdentifierTypeStateIssuer
2039567OtherINTERNAL ID-MOTOR VEHICLE ID
8439119MedicaidWA
0271925OtherWALABOR AND INDUSTRY

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address bscottvessel1163480@wm.providencedirect.org
Direct Messaging Address bscottvessel1163480@wm.providencedirect.org

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
I20050106000627 WA Practitioner - Physician Assistant 8921056953 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA10004743WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Care Washington PLLC CurrentSince Apr 27, 2020 Accepting new patients
Providence Health & Services - Washington CurrentSince Nov 4, 2019 Accepting new patients
Optum Care Washington PLLC CurrentSince Apr 27, 2020 Accepting new patients
Providence Health & Services- Washington CurrentSince Nov 4, 2019 Accepting new patients
Sage Medical Group, PLLC CurrentSince Apr 11, 2012 Accepting new patients

Locations

12600 SE 38th St
Ste 130
Bellevue, WA 98006
Phone (425) 679-6056

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

1321 Colby Ave
Everett, WA 98201
Phone (425) 259-4413

1717 13th St
Everett, WA 98201
Phone (425) 297-5500

4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

Interoperability endpoints

  • Direct secure messaging: bscottvessel1163480@wm.providencedirect.org

Organizations & group practices 5

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1881774859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5127",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982065127",
            "telephone_number": "425-258-3900",
            "fax_number": "425-297-5561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 13TH ST",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011621",
            "telephone_number": "425-258-3900",
            "fax_number": "425-297-5561"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13720 41st Ave NE",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981253821",
            "country_code": "US",
            "telephone_number": "206-579-6379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCOTT-VESSEL",
        "first_name": "BRANDEA",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10004743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERNAL ID-MOTOR VEHICLE ID",
            "identifier": "2039567",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8439119",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRY",
            "identifier": "0271925",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bscottvessel1163480@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "1717 13th St",
            "city": "Everett",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982011621",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bscottvessel1163480@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "1321 Colby Ave",
            "city": "Everett",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982011665",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.