NPIMap

Organization Active NPI

The Aesthetic Surgery Centre, PLLC

  • Specialist
  • Tacoma, WA
National Provider Identifier
1952682767
Registry record updated Oct 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
601963666 Issued in WA
Legal business name
THE AESTHETIC SURGERY CENTRE, PLLC
Practice address
2202 S Cedar St
Suite 100
Tacoma, WA 98405-2318
Phone
(253) 627-2900
Fax
(253) 627-2941
NPI assigned
Sep 7, 2011
Last updated
Oct 14, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2015

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

Authorized official

Name
Dr. David Pratt, MDNPI 1730164963
Title
Doctor
Phone
(253) 627-2900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 601963666 WA Primary

Addresses

Primary practice location

2202 S Cedar St
Suite 100
Tacoma, WA 98405-2318

Mailing address

2202 S Cedar St
Suite 100
Tacoma, WA 98405-2318
Phone (253) 627-2900

Other identifiers 1

IdentifierTypeStateIssuer
7131055MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120229000172 WA Part B Supplier - Clinic/Group Practice 4688841851 Receives reassigned benefits from 6 practitioners
2 other NPIs on this enrollment
Practice locations: Federal Way, WA; Gig Harbor, WA; Lakewood, WA; Tacoma, WA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
The Aesthetic Surgery Centre PLLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1315353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444780800000",
    "number": "1952682767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 S CEDAR ST",
            "address_2": "SUITE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984052318",
            "telephone_number": "253-627-2900",
            "fax_number": "253-627-2941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 S CEDAR ST",
            "address_2": "SUITE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984052318",
            "telephone_number": "253-627-2900",
            "fax_number": "253-627-2941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE AESTHETIC SURGERY CENTRE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-07",
        "last_updated": "2015-10-14",
        "status": "A",
        "authorized_official_last_name": "PRATT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "253-627-2900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "601963666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7131055",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.