Individual provider Active NPI

Michael Watrobka, PAC

  • Medical Physician Assistant
  • Bellingham, WA
National Provider Identifier
1902348709
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA60753618 Issued in WA
Practice address
220 Unity St
Bellingham, WA 98225-4420
Phone
(360) 676-6177
Fax
(360) 671-3574
NPI assigned
Nov 9, 2016
Last updated
May 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-1450 ID
Medical Physician Assistant 363AM0700X PA60753618 WA Primary

Addresses

Primary practice location

220 Unity St
Bellingham, WA 98225-4420

Mailing address

700 W Ironwood Dr
Suite 220 E
Coeur D Alene, ID 83814-2656

Other identifiers 1

IdentifierTypeStateIssuer
PA-1450OtherIDSTATE LICENSE

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
I20170705001693 WA Practitioner - Physician Assistant 5698055978

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unity Care NorthwestGroup PAC ID 7911897699, shared by 5 NPIs, 39 clinicians

Practice addresses (Care Compare)

1500 N State St
Bellingham, WA 98225-4551
Phone (360) 676-6177

220 Unity St
Bellingham, WA 98225-4420
Phone (360) 676-6177

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Unity Care Northwest CurrentSince May 28, 2024 Accepting new patients
Unity Care Northwest CurrentSince May 28, 2024 Accepting new patients

Locations

1616 Cornwall Ave
Ste 205
Bellingham, WA 98225
Phone (360) 656-6177

220 Unity St
Bellingham, WA 98225
Phone (206) 540-7494

Interoperability endpoints

  • Direct secure messaging: mwatrobka748748@direct.ochin.org

Organizations & group practices 2

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": "1478649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1902348709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 W IRONWOOD DR",
            "address_2": "SUITE 220 E",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 UNITY ST",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982254420",
            "telephone_number": "360-676-6177",
            "fax_number": "360-671-3574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATROBKA",
        "first_name": "MICHAEL",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-09",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-1450",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA60753618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PA-1450",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

Verify at the official NPI Registry.