Individual provider Active NPI

Anthony Xudong Fan, M.D.

  • Anesthesiology Physician
  • Seattle, WA
National Provider Identifier
1932245735
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD00045828 Issued in WA
Practice address
1550 N 115TH St
Seattle, WA 98133-8401
Phone
(206) 520-5000
NPI assigned
Jan 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Anesthesiology) Physician 207LC0200X MD00045828 WA
Anesthesiology Physician 207L00000X MD00045828 WA Primary

Addresses

Primary practice location

1550 N 115TH St
Seattle, WA 98133-8401

Mailing address

PO Box 50095
Seattle, WA 98145-5095

Other practice location 1

1959 NE Pacific St.
Seattle, WA 98195-0001
Phone (206) 520-5000

Other practice location 2

325 9th Ave
Seattle, WA 98104-2420
Phone (206) 520-5000

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
I20070425000565 WA Practitioner - AnesthesiologyPractitioner - Critical Care (Intensivists) 5991801680 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00045828WAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Association of University Physicians Anesthesiology CurrentSince Oct 1, 2023 Accepting new patients
The Association of Chrmc and University Physicians Anesthesiology CurrentSince Feb 12, 2026 Accepting new patients
Physicians Anesthesia Service PLLC Anesthesiology CurrentSince Aug 1, 2006 Accepting new patients
Franciscan Medical Group Current Accepting new patients
Fan PLLC Anesthesiology Current Accepting new patients
Western Washington Medical Group, Inc, PS CurrentSince Aug 1, 2006 Accepting new patients
Association of CHMC and University Physicians CurrentSince Feb 12, 2026 Accepting new patients

Locations

1229 Madison St
Ste 1440
Seattle, WA 98104
Phone (206) 625-0578

325 9th Ave
Seattle, WA 98104
Phone (206) 731-3000

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000

1550 N 115th St
Shoreline, WA 98133
Phone (206) 364-0500

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

Organizations & group practices 7

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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1932245735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 N 115TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981338401",
            "telephone_number": "206-520-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1959 NE PACIFIC ST.",
            "address_purpose": "LOCATION",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981950001",
            "country_code": "US",
            "telephone_number": "206-520-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "325 9th Ave",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981042420",
            "country_code": "US",
            "telephone_number": "206-520-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAN",
        "first_name": "ANTHONY",
        "middle_name": "XUDONG",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "WA",
            "license": "MD00045828",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "MD00045828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.