Individual provider Active NPI

Craig Pastor, MD

  • Orthopaedic Hand Surgery Physician
  • Edmonds, WA
National Provider Identifier
1962664201
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Hand Surgery PhysicianTaxonomy code 207XS0106X
License
MD60474913 Issued in WA
Practice address
21401 72ND Ave W
Edmonds, WA 98026-7702
Phone
(425) 412-1875
Fax
(425) 304-1103
NPI assigned
Jun 27, 2008
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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD60474913 WA
Orthopaedic Hand Surgery Physician 207XS0106X MD60474913 WA Primary

Addresses

Primary practice location

21401 72ND Ave W
Edmonds, WA 98026-7702

Mailing address

PO Box 5127
Everett, WA 98206-5127
Phone (425) 225-3900

Other practice location 1

19930 Ballinger Way NE
Shoreline, WA 98155
Phone (425) 778-2220 ext. 217

Other practice location 2

9924 NE 185th St
Bothell, WA 98011-3502
Phone (425) 595-3830

Other identifiers 1

IdentifierTypeStateIssuer
1962664201OtherNPI

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151209002999 WA Practitioner - Hand Surgery 8022319300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hand Surgery
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Care Washington PLLCGroup PAC ID 6406752153, 684 clinicians

Practice addresses (Care Compare)

21401 72ND Ave W
Edmonds, WA 98026-7702
Phone (425) 304-1101

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Care Washington PLLC CurrentSince Oct 16, 2018 Accepting new patients
Optum Care Washington PLLC CurrentSince Oct 16, 2018 Accepting new patients
Optum Care Washington PLLC PastSince Apr 14, 2024 Accepting new patients
Optum Care Washington PLLC Past Accepting new patients

Locations

21401 72nd Ave W
Edmonds, WA 98026
Phone (425) 304-1101

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

Interoperability endpoints

  • Direct secure messaging: cpastor17210@direct.tecmc.com

Organizations & group practices 4

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": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1962664201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5127",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982065127",
            "telephone_number": "425-225-3900",
            "fax_number": "425-258-3910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21401 72ND AVE W",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267702",
            "telephone_number": "425-412-1875",
            "fax_number": "425-304-1103"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19930 Ballinger Way NE",
            "address_purpose": "LOCATION",
            "city": "Shoreline",
            "state": "WA",
            "postal_code": "98155",
            "country_code": "US",
            "telephone_number": "425-778-2220 x217",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9924 NE 185th St",
            "address_purpose": "LOCATION",
            "city": "Bothell",
            "state": "WA",
            "postal_code": "980113502",
            "country_code": "US",
            "telephone_number": "425-595-3830",
            "fax_number": "425-595-3831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PASTOR",
        "first_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-27",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MD60474913",
            "primary": false
        },
        {
            "code": "207XS0106X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Hand Surgery",
            "state": "WA",
            "license": "MD60474913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1962664201",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

Verify at the official NPI Registry.