Public Hospital District No 1 of Mason County Washington
Organization Active NPI Ophthalmologic Surgery Clinic/Center · Shelton, WA
NPI 1922196609 · NPPES record last updated Jul 15, 2011
Key facts
- NPI
- 1922196609
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ophthalmologic Surgery Clinic/Center 261QS0132X
- Legal business name
- PUBLIC HOSPITAL DISTRICT NO 1 OF MASON COUNTY WASHINGTON
- Practice address
- 2300 Kati CT
Suite C
Shelton, WA 98584-1926 - Phone
- (360) 426-8717
- NPI assigned
- Oct 10, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. George Robert Appel
- Title
- Chief Executive Officer
- Phone
- (360) 427-9556
Other NPIs on the same Medicare enrollment 13
Related certifications (CCN) 5
Practitioners 1
-
Monica B Vuong, MD
Affiliated clinicians 255
-
Scott B Adams, PAC
-
Anam Akmal, M.D
-
Frederick Edward Albrecht, M.D. PHD
-
Charles W Anderegg, PAC
-
David Eric Anderson, M.D.
-
Karen Lisa Arndt, ARNP
-
Natasha P Arora, MD
-
Trevor Barronian, MD
-
Hanan Batarseh, MD
-
John C. Bausher, MD, PHD
-
Jawaid Ahmad Behnawa, M.D
-
Thomas Long Belanger Jr., M.D.
-
James E. Bell I, MD
-
Roy G Belville, MD
-
Chad Bender, MD
-
Marina V Berndt, MD
-
Evgeny A Bistrika, D.O.
-
Danielle Blood, MD
-
Yuri A Bobko, PA-C
-
Kaitlin G Bock, ARNP
-
Carola E Bonfante, M.D.
-
Daniel Mark Brown, M.D.
-
David Leroy Brown, M.D.
Medicare Care Compare: Hospital
- Listed as
- Mason General Hospital & Family of Clinics
- Overall star rating
- ★★☆☆☆ 2 of 5
- Type
- Critical Access Hospitals
- Ownership
- Government - Hospital District or Authority
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WA
Hospital certification: CCN 501336
- Legal name
- PUBLIC HOSPITAL DISTRICT NO 1 OF MASON COUNTY
- Doing business as
- MASON GENERAL HOSPITAL & FAMILY OF CLINICS
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- Jan 1, 2005
- Last certification
- Jan 22, 2016
- Beds
- 25
- Ownership / control type
- Hospital district or authority
- Organization structure
- Government · Non-profit
- Enrollment address
- 901 Mt View Dr
Shelton, WA 98584-4401
All disclosed owners & managing parties 4
| Name | Role | Since | Share |
|---|---|---|---|
| Eric C Moll |
Corporate Director | Jul 1, 2004 | |
| W-2 Managing Employee | Jul 1, 2004 | ||
| Stephen Leslie |
W-2 Managing Employee | Dec 31, 2022 | |
| Gayle Weston |
Corporate Officer | Nov 1, 2021 | |
| Darrin Moody |
Corporate Officer | Nov 1, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040310001481 | WA | Part B Supplier - Clinic/Group Practice | 0345139275 |
Receives reassigned benefits from 180 practitioners 10 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Shelton, WA; Olympia, WA; Hoodsport, WA |
| O20050106000705 | WA | Part a Provider - Critical Access Hospital | 0345139275 |
Receives reassigned benefits from 52 practitioners 4 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Shelton, WA |
National Provider Directory
Locations
939 Mountain View Dr
Shelton, WA 98584
Phone (360) 426-0663
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | WA | ||
| Ophthalmology Physician |
207W00000X | WA | ||
| Ophthalmologic Surgery Clinic/Center | 261QS0132X | Yes |
Addresses
Primary practice location
2300 Kati CT
Suite C
Shelton, WA 98584-1926
Mailing address
2300 Kati CT
Suite C
Shelton, WA 98584-1900
Phone (360) 426-8717
Other names
- Mason County Eye Clinic
Other providers in Shelton, WA
- Public Hospital District No 1 of Mason County
- Public Hospital District No 1 of Mason County Wa
- Public Hospital District No 1 of Mason County Washington
- Public Hospital District No 1 of Mason County Washington
- Public Hospital District No 1 of Mason County Washington
- Public Hospital District No. 1 of Mason County Washington
- Alexandria Phoenix Quigley
- Naomi E Ramsey
- Viswanathan Rangan
- Celso Rangel Jr.
All providers in Shelton, WA · Ophthalmologic Surgery Clinic/Center in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 15, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.