NPIMap

Organization Active NPI

Pacific Northwest Urology Specialists, PLLC

Doing business as Pacific Northwest Urology Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Bellingham, WA
National Provider Identifier
1952852873
Registry record updated Oct 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
PACIFIC NORTHWEST UROLOGY SPECIALISTS, PLLC
Doing business as
Pacific Northwest Urology Surgery Center
Practice address
3232 Squalicum Pkwy
Bellingham, WA 98225-1932
Phone
(360) 733-7687
Fax
(360) 734-7687
NPI assigned
Oct 14, 2016
Last updated
Oct 14, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2016

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

Authorized official

Name
Reanna D Furnari
Title
Administrator
Phone
(360) 733-7687

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

3232 Squalicum Pkwy
Bellingham, WA 98225-1932

Mailing address

PO Box 32150
Bellingham, WA 98228-4150
Phone (360) 733-7687

Other names 1

  • Pacific Northwest Urology Surgery Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170703001901 WA Part B Supplier - Ambulatory Surgical Center 6103137096 Practice locations: Bellingham, WA

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Pacific Northwest Urology Surgery CenterCCN 50C0001320
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2133311Pacific Northwest Urology Surgery Center3232 Squalicum Pkwy, Bellingham, WA 98225Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Locations

4545 Cordata Pkwy
Ste 1A
Bellingham, WA 98226
Phone (360) 733-7687

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1476403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476403200000",
    "number": "1952852873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32150",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982284150",
            "telephone_number": "360-733-7687",
            "fax_number": "360-734-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3232 SQUALICUM PKWY",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251932",
            "telephone_number": "360-733-7687",
            "fax_number": "360-734-7687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC NORTHWEST UROLOGY SPECIALISTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-14",
        "last_updated": "2016-10-14",
        "status": "A",
        "authorized_official_last_name": "FURNARI",
        "authorized_official_first_name": "REANNA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "360-733-7687"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Northwest Urology Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.