Individual provider Active NPI

Michael E. Crook, M.D.

  • Pediatrics Physician
  • Yakima, WA
National Provider Identifier
1922103803
Registry record updated Feb 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD00040061 Issued in WA
Practice address
402 S 12TH Ave
Yakima, WA 98902-3115
Phone
(509) 575-0114
Fax
(509) 575-0808
NPI assigned
Sep 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD00040061 WA Primary

Addresses

Primary practice location

402 S 12TH Ave
Yakima, WA 98902-3115

Mailing address

501 S 5TH Ave
Yakima, WA 98902-3550
Phone (509) 494-6700

Other identifiers 2

IdentifierTypeStateIssuer
8295362MedicaidWA
8941846OtherWAL&I CRIME VICTIM

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
I20051213000132 WA Practitioner - Pediatric Medicine 9638190135 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00040061WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health of Central Washington CurrentSince Aug 4, 2010 Accepting new patients
Community Health of Central Washington CurrentSince Aug 4, 2010 Accepting new patients

Locations

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

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

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

314 S 11th Ave
Ste A
Yakima, WA 98902
Phone (509) 575-0114

Interoperability endpoints

  • Direct secure messaging: mcrook606012@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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580688000000",
    "number": "1922103803",
    "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": "509-494-6700",
            "fax_number": "509-573-6275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 S 12TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023115",
            "telephone_number": "509-575-0114",
            "fax_number": "509-575-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROOK",
        "first_name": "MICHAEL",
        "middle_name": "E.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00040061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8295362",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I CRIME VICTIM",
            "identifier": "8941846",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.