Individual provider Active NPI

David Isaac

  • Psychiatric/Mental Health Nurse Practitioner
  • Yakima, WA
National Provider Identifier
1962089227
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
N361155964 Issued in WA
Practice address
402 S 4TH Ave
Yakima, WA 98902-3546
Phone
(509) 575-4084
NPI assigned
Mar 24, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X N361155964 WA Primary

Addresses

Primary practice location

402 S 4TH Ave
Yakima, WA 98902-3546

Mailing address

402 S 4TH Ave
Yakima, WA 98902-3546

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
I20210621000345 WA Practitioner - Nurse Practitioner 0446650956 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
N361155964WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Healthcare CurrentSince May 17, 2021 Accepting new patients
Comprehensive Healthcare CurrentSince May 17, 2021 Accepting new patients

Locations

402 S 4th Ave
Yakima, WA 98902
Phone (509) 575-3874

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1962089227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 S 4TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 S 4TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023546",
            "telephone_number": "509-575-4084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISAAC",
        "first_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-24",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "N361155964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.