Individual provider Active NPI

Marta Grace Geldaker Swanson, PA-C

  • Surgical Physician Assistant
  • Mount Vernon, WA
National Provider Identifier
1932795895
Registry record updated Jan 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA61226923 Issued in WA
Practice address
1400 E Kincaid St
Mount Vernon, WA 98274-4127
Phone
(360) 428-2586
Fax
(360) 428-6470
NPI assigned
Dec 15, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA61226923 WA Primary

Addresses

Primary practice location

1400 E Kincaid St
Mount Vernon, WA 98274-4127

Mailing address

1400 E Kincaid St
Mount Vernon, WA 98274-4127

Other names 1

  • Marta Geldaker Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mswanson37480@skagit.direct-ci.com Direct

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220126002864 WA Practitioner - Physician Assistant 8022400993 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PeacehealthGroup PAC ID 9537073960, 292 clinicians

Practice addresses (Care Compare)

2901 Sqaulicum Pkwy
Bellingham, WA 98225-1851
Phone (360) 788-9373

2979 Squalicum Pkwy
Bellingham, WA 98225-1813
Phone (360) 756-6800

2980 Squalicum Pkwy
Bellingham, WA 98225-1880
Phone (360) 788-6112

3015 Squalicum Pkwy
Bellingham, WA 98225-1906

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital Dist No 1 Skagit CurrentSince Jan 17, 2022 Accepting new patients
Peacehealth CurrentSince Jan 24, 2022 Accepting new patients
Public Hospital Dist No 1 Skagit CurrentSince Jan 17, 2022 Accepting new patients

Locations

3015 Squalicum Pkwy
Ste 200
Bellingham, WA 98225
Phone (360) 733-2092

3015 Squalicum Pkwy
Ste 100
Bellingham, WA 98225
Phone (360) 715-4186

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

Organizations & group practices 5

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 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": "1607990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1932795895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 E KINCAID ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E KINCAID ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744127",
            "telephone_number": "360-428-2586",
            "fax_number": "360-428-6470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWANSON",
        "first_name": "MARTA",
        "middle_name": "GRACE GELDAKER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-15",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA61226923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mswanson37480@skagit.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "Provider Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1400 E Kincaid St",
            "city": "Mount Vernon",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982744127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARTA",
            "last_name": "GELDAKER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mount Vernon, WA

Sources for this page

Verify at the official NPI Registry.