NPIMap

Individual provider Active NPI

Rayleen Amy Greathouse, PA-C

  • Physician Assistant
  • Federal Way, WA
National Provider Identifier
1952319972
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60271754 Issued in WA
Practice address
32018 23Rd Ave S
Federal Way, WA 98003-6022
Phone
(253) 839-3030
Fax
(206) 520-1799
NPI assigned
Aug 4, 2006
Last updated
Nov 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA60271754 WA Primary

Addresses

Primary practice location

32018 23Rd Ave S
Federal Way, WA 98003-6022

Mailing address

127 S 500 E Ste 600
Salt Lake City, UT 84102-1971
Phone (801) 587-6336

Other identifiers 2

IdentifierTypeStateIssuer
0293199OtherWAL&I
1952319972MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address V=rgreathouse126748@direct.med.utah.edu Direct UNIVERSITY OF UTAH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20150109001261 UT Practitioner - Physician Assistant 9537177282 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1525 W 2100
Salt Lake City, UT 84119-1407
Phone (801) 213-9900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.01 of 100Reported as group
Quality
94.06
Promoting interoperability
100
Improvement activities
40
Cost
69.32

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
703AKMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Community Physicians Group CurrentSince Jul 1, 2015 Accepting new patients
University of Utah Community Physicians Group Past Accepting new patients
Association of University Physicians Past Accepting new patients

Locations

1525 W 2100 S
Salt Lake City, UT 84119
Phone (801) 213-8841

Interoperability endpoints

  • Direct secure messaging: rgreathouse126748@direct.med.utah.edu
  • Direct secure messaging: v=rgreathouse126748@direct.med.utah.edu

Organizations & group practices 3

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1952319972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 S 500 E STE 600",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021971",
            "telephone_number": "801-587-6336",
            "fax_number": "801-587-6459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32018 23RD AVE S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036022",
            "telephone_number": "253-839-3030",
            "fax_number": "206-520-1799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREATHOUSE",
        "first_name": "RAYLEEN",
        "middle_name": "AMY",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60271754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I",
            "identifier": "0293199",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952319972",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "V=rgreathouse126748@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "UNIVERSITY OF UTAH",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

Verify at the official NPI Registry.