Kitsap General Surgery PLLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

KITSAP GENERAL SURGERY PLLC

Practice address

9927 Mickelberry Rd NW
Suite 121
Silverdale, WA 98383-9195

Phone

(360) 613-1335

Fax

(360) 613-1329

NPI assigned

Aug 16, 2006

Last updated

Nov 15, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ty Chun, M.D.NPI 1659484699

Title

Physicianpartner

Phone

(360) 613-1335

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IBADAA

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kristan David Guenterberg, MD

  • Surgery Physician
  • Silverdale, WA
  • NPI 1659593754
  Medicare reassignment Care Compare group
• Thomas Wixted, MD

  • Surgery Physician
  • Silverdale, WA
  • NPI 1841343514
  Medicare reassignment Care Compare group
• Ty Chun, M.D.

  • Surgery Physician
  • Silverdale, WA
  • NPI 1659484699
  Authorized official Same address or phone
• Kimberly Ming Chan, M.D.

  • Surgery Physician
  • Silverdale, WA
  • NPI 1194896779
  NPD (past)

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352937600000",
    "number": "1912010984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9927 MICKELBERRY RD NW",
            "address_2": "SUITE 121",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983839195",
            "telephone_number": "360-613-1335",
            "fax_number": "360-613-1329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9927 MICKELBERRY RD NW",
            "address_2": "SUITE 121",
            "city": "SILVERDALE",
            "state": "WA",
            "postal_code": "983839195",
            "telephone_number": "360-613-1335",
            "fax_number": "360-613-1329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KITSAP GENERAL SURGERY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2012-11-15",
        "status": "A",
        "authorized_official_last_name": "CHUN",
        "authorized_official_first_name": "TY",
        "authorized_official_title_or_position": "PHYSICIANPARTNER",
        "authorized_official_telephone_number": "360-613-1335",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7134984",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kitsap Audiology, Inc. (Hearing Solutions)
• Kitsap Children's Speech Therapy
• Kitsap Childrens Clinic
• Kitsap Eyecare, Inc
• Kitsap Family Wellness LLC
• Kitsap Medical Supply, LLC
• Kitsap OBGYN PLLC
• Kitsap Optical Inc
• Kitsap Physical Therapy and Sports Clinic PS Inc
• Kitsap Physical Therapy and Sports Clinic PS Inc

• Surgery Physician in Silverdale, WA
• Providers in Silverdale, WA by specialty
• Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; 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.

Verify at the official NPI Registry.