Individual provider Active NPI

Carl R Olden, MD

  • Family Medicine Physician
  • Yakima, WA
National Provider Identifier
1922022037
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00021916 Issued in WA
Practice address
1806 W Lincoln Ave
Yakima, WA 98902-2473
Phone
(509) 452-4520
Fax
(509) 452-5224
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00021916 WA Primary

Addresses

Primary practice location

1806 W Lincoln Ave
Yakima, WA 98902-2473

Mailing address

501 S 5TH Ave
Yakima, WA 98902-3550
Phone (098) 531-0825

Other practice location 1

311 S 72nd Ave
Yakima, WA 98908
Phone (509) 972-1818

Other identifiers 1

IdentifierTypeStateIssuer
1022206MedicaidWA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051130000275 WA Practitioner - Family Practice 1557381910 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Washington School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1806 W Lincoln Ave
Yakima, WA 98902-2473
Phone (509) 452-4520

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00021916WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yakima Valley Memorial Physicians CurrentSince Sep 1, 2020 Accepting new patients
Yakima Valley Memorial Physicians CurrentSince Sep 1, 2020 Accepting new patients
Community Health of Central Washington CurrentSince Oct 1, 2024 Accepting new patients
Community Health of Central Washington Family Medicine CurrentSince Oct 1, 2024 Accepting new patients
Community Health of Central Washington Past Accepting new patients
Community Health of Central Washington Family Medicine Past Accepting new patients

Locations

521 E Mountain View Ave
Ellensburg, WA 98926
Phone (509) 962-1414

504 N 40th Ave
Yakima, WA 98908

2811 Tieton Dr
Yakima, WA 98902
Phone (509) 249-5210

402 S 12th Ave
Yakima, WA 98902
Phone (509) 248-3263

406 S 30th Ave
Ste 101
Yakima, WA 98902
Phone (509) 248-7715

402 S 12th Ave
Bsmt
Yakima, WA 98902

311 S 72nd Ave
Yakima, WA 98908
Phone (509) 927-1818

3003 Tieton Dr
Ste 210
Yakima, WA 98902
Phone (509) 249-5180

501 S 5th Ave
Yakima, WA 98902
Phone (509) 494-6700

1806 W Lincoln Ave
Yakima, WA 98902
Phone (509) 452-4520

Interoperability endpoints

  • Direct secure messaging: colden748268@direct.ochin.org
  • Direct secure messaging: colden773009@direct.multicare.org

Organizations & group practices 6

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1922022037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S 5TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023550",
            "telephone_number": "098-531-0825",
            "fax_number": "509-573-6275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 W LINCOLN AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989022473",
            "telephone_number": "509-452-4520",
            "fax_number": "509-452-5224"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "311 S 72nd Ave",
            "address_purpose": "LOCATION",
            "city": "Yakima",
            "state": "WA",
            "postal_code": "98908",
            "country_code": "US",
            "telephone_number": "509-972-1818",
            "fax_number": "509-225-2706",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLDEN",
        "first_name": "CARL",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00021916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1022206",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.