NPIMap

Individual provider Active NPI

Stephen T Erickson, MD

  • Family Medicine Physician
  • Port Townsend, WA
National Provider Identifier
1932259587
Registry record updated Feb 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
48329 Issued in CO
Practice address
1010 Sheridan St
Suite 202
Port Townsend, WA 98368-2901
Phone
(360) 385-5388
Fax
(360) 385-0433
NPI assigned
Jan 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 39311 WI
Family Medicine Physician 207Q00000X 48329 CO Primary

Addresses

Primary practice location

1010 Sheridan St
Suite 202
Port Townsend, WA 98368-2901

Mailing address

1010 Sheridan St
Suite 202
Port Townsend, WA 98368-2901
Phone (360) 385-5388

Other identifiers 2

IdentifierTypeStateIssuer
32423500MedicaidWI
25939742MedicaidCO

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
I20130128000136 WA Practitioner - Family Practice 8628069879 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson County Public Hospital District No 2Group PAC ID 4789593708, 151 clinicians

Practice addresses (Care Compare)

1010 Sheridan St
Port Townsend, WA 98368-2901
Phone (360) 385-3500

89 Breaker LN
Port Ludlow, WA 98365-9766
Phone (360) 437-5067

915 Sheridan St
Port Townsend, WA 98368-2931
Phone (360) 379-8031

934 Sheridan St
Port Townsend, WA 98368-2957
Phone (360) 385-5338

Hospital & facility affiliations

  • Jefferson Healthcare Home Health Home health agency, Port Townsend, WA, CCN 507050
  • Jefferson Healthcare Hospital, Port Townsend, WA, CCN 501323
  • Olympic Medical Center Hospital, Port Angeles, WA, CCN 500072
  • St Michael Medical Center Hospital, Silverdale, WA, CCN 500039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
48329COMDFamily Medicine Physician
39311WIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson County Public Hospital District No 2 CurrentSince Nov 26, 2012 Accepting new patients
Jefferson County Public Hospital District No 2 CurrentSince Nov 26, 2012 Accepting new patients
Southeast Alaska Regional Health Consortium Past Accepting new patients
Gustavus Community Clinic Inc Past Accepting new patients

Locations

1200 W Sims Way
Ste C
Port Townsend, WA 98368
Phone (360) 385-6297

1010 Sheridan St
Ste 101
Port Townsend, WA 98368
Phone (360) 379-8031

1010 Sheridan St
Ste 202
Port Townsend, WA 98368
Phone (360) 385-5388

834 Sheridan St
Port Townsend, WA 98368
Phone (360) 344-0400

934 Sheridan St
Port Townsend, WA 98368
Phone (360) 385-5330

Interoperability endpoints

  • Direct secure messaging: serickson296943@wm.providencedirect.org

Organizations & group practices 12

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.

Hospital & facility affiliations 6

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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361836800000",
    "number": "1932259587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 SHERIDAN ST",
            "address_2": "SUITE 202",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983682901",
            "telephone_number": "360-385-5388",
            "fax_number": "360-385-0433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 SHERIDAN ST",
            "address_2": "SUITE 202",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983682901",
            "telephone_number": "360-385-5388",
            "fax_number": "360-385-0433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "STEPHEN",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2013-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "39311",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "48329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32423500",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "25939742",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Townsend, WA

Sources for this page

Verify at the official NPI Registry.