NPIMap

Individual provider Active NPI

William W Stopoulos, PA-C

  • Physician Assistant
  • Edmonds, WA
National Provider Identifier
1922351501
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60446696 Issued in WA
Practice address
7315 212TH St SW Ste 205
Edmonds, WA 98026-7610
Phone
(425) 776-6999
Fax
(425) 776-9899
NPI assigned
Oct 19, 2012
Last updated
Dec 1, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA60446696 WA
Physician Assistant 363A00000X PA60446696 WA Primary

Addresses

Primary practice location

7315 212TH St SW Ste 205
Edmonds, WA 98026-7610

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476

Other identifiers 1

IdentifierTypeStateIssuer
2049734MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140505001270 WA Practitioner - Physician Assistant 6103870456 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Swedish Health ServicesGroup PAC ID 7517870645, 79 clinicians

Practice addresses (Care Compare)

21601 76TH Ave W
Edmonds, WA 98026-7507
Phone (425) 640-4000

7320 216TH St SW
Suite 210
Edmonds, WA 98026-8006
Phone (425) 744-1777

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.46 of 100Reported as group
Quality
80.66
Promoting interoperability
100
Improvement activities
40
Cost
77.55

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA60446696WAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital Dist No 1 Skagit CurrentSince Dec 7, 2015 Accepting new patients
Swedish Health Services CurrentSince Nov 7, 2022 Accepting new patients
Swedish Health Services Past Accepting new patients

Locations

12917 SE 38th St
Ste 100
Bellevue, WA 98006
Phone (206) 292-7990

7315 212th St SW
Ste 205
Edmonds, WA 98026
Phone (425) 774-2020

7320 216th St SW
Ste 210
Edmonds, WA 98026
Phone (206) 292-7990

1400 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 428-2586

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1350604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1922351501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7315 212TH ST SW STE 205",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267610",
            "telephone_number": "425-776-6999",
            "fax_number": "425-776-9899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOPOULOS",
        "first_name": "WILLIAM",
        "middle_name": "W",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-19",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA60446696",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60446696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2049734",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

Verify at the official NPI Registry.