NPIMap

Organization Active NPI

Emergency Medicine Associates PC

  • Emergency Medicine Physician
  • Vancouver, WA
National Provider Identifier
1962453860
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
601287343 Issued in WA
Legal business name
EMERGENCY MEDICINE ASSOCIATES PC
Practice address
600 NE 92ND Ave
Vancouver, WA 98664-3225
Phone
(360) 514-2000
Fax
(360) 514-6820
NPI assigned
May 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Authorized official

Name
Daniel M Gorecki, MDNPI 1245278431
Title
MD/Authorized Official
Phone
(360) 514-2142

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X 601287343 WA Primary
Emergency Care Clinic/Center 261QE0002X

Addresses

Primary practice location

600 NE 92ND Ave
Vancouver, WA 98664-3225

Mailing address

PO Box 742997
Los Angeles, CA 90074-2997
Phone (781) 280-1773

Other identifiers 3

IdentifierTypeStateIssuer
7128507MedicaidWA
278137MedicaidOR
DE1747OtherWARAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050912000784 WA Part B Supplier - Clinic/Group Practice 3870526858 Receives reassigned benefits from 82 practitioners
Practice locations: Vancouver, WA

National Provider Directory

National Provider Directory

Locations

602 NE 92nd Ave
Vancouver, WA 98664

600 NE 92nd Ave
Vancouver, WA 98664
Phone (360) 514-2142

Practitioners & affiliated clinicians

Practitioners 97

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 97

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641340800000",
    "number": "1962453860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742997",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900742997",
            "telephone_number": "781-280-1773",
            "fax_number": "781-280-1814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 NE 92ND AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986643225",
            "telephone_number": "360-514-2000",
            "fax_number": "360-514-6820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERGENCY MEDICINE ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A",
        "authorized_official_last_name": "GORECKI",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MD/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "360-514-2142",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "601287343",
            "primary": true
        },
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7128507",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "278137",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE1747",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; 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.