Active NPI
Proliance Surgeons, Inc., P.S.
Doing business as Proliance Puget Sound Orthopaedics
- Durable Medical Equipment & Medical Supplies
- Gig Harbor, WA
National Provider Identifier
1902418189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Legal business name
- PROLIANCE SURGEONS, INC., P.S.
- Doing business as
- Proliance Puget Sound Orthopaedics
- Practice address
- 2727 Hollycroft St Ste 410
Gig Harbor, WA 98335-1369 - Phone
- (253) 358-4002
- Fax
- (253) 358-4015
- NPI assigned
- Aug 19, 2020
- Last updated
- Aug 19, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Cori M. Pleasant
- Title
- MGR Provider Relations/Enrollment
- Phone
- (206) 838-2585
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | NU | ||
| Orthopaedic Hand Surgery Physician | 207XS0106X | NU | ||
| Adult Reconstructive Orthopaedic Surgery Physician | 207XS0114X | NU | ||
| Orthopaedic Surgery of the Spine Physician | 207XS0117X | NU | ||
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | NU | ||
| Durable Medical Equipment & Medical Supplies | 332B00000X | NU | Primary | |
| Surgical Physician Assistant | 363AS0400X | NU |
Addresses
Primary practice location
2727 Hollycroft St Ste 410
Gig Harbor, WA 98335-1369
Mailing address
7308 Bridgeport Way W Ste 201
Lakewood, WA 98499-8000
Phone (253) 582-7257
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0532700053 | Other | WA | DME |
Other names 1
- Proliance Puget Sound Orthopaedics
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20201216000308 | WA | DME Supplier - Multi-Specialty - Physician | 8527972900 | Practice locations: Gig Harbor, WA |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597795200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1660867200000",
"number": "1902418189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7308 BRIDGEPORT WAY W STE 201",
"city": "LAKEWOOD",
"state": "WA",
"postal_code": "984998000",
"telephone_number": "253-582-7257",
"fax_number": "253-722-0388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2727 HOLLYCROFT ST STE 410",
"city": "GIG HARBOR",
"state": "WA",
"postal_code": "983351369",
"telephone_number": "253-358-4002",
"fax_number": "253-358-4015"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PROLIANCE SURGEONS, INC., P.S.",
"organizational_subpart": "NO",
"enumeration_date": "2020-08-19",
"last_updated": "2022-08-19",
"certification_date": "2022-08-19",
"status": "A",
"authorized_official_last_name": "PLEASANT",
"authorized_official_first_name": "CORI",
"authorized_official_middle_name": "M.",
"authorized_official_title_or_position": "MGR PROVIDER RELATIONS/ENROLLMENT",
"authorized_official_telephone_number": "206-838-2585"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207XS0106X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Hand Surgery",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207XS0114X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207XS0117X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207XX0005X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Sports Medicine",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DME",
"identifier": "0532700053",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Proliance Puget Sound Orthopaedics",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Gig Harbor, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; 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.