Phillip A Dean, M.D.,

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

MD60513550 Issued in WA

Practice address

4011 Talbot Rd S Ste 420
Renton, WA 98055-5791

Phone

(425) 690-3401

Fax

(425) 690-9401

NPI assigned

Nov 8, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Valley Medical Group-Renton

  • General Acute Care Hospital
  • Renton, WA
  • NPI 1619209574
  Medicare reassignment NPD
• Saginaw Colon and Rectal Surgery,PC

  • Specialist
  • Saginaw, MI
  • NPI 1831200500
  NPD (past) Authorized official
• Mid Michigan Surgical Specialists P C

  • Surgery Physician
  • Saginaw, MI
  • NPI 1528011921
  NPD (past)

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584316800000",
    "number": "1972584936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 LIND AVE SW",
            "address_2": "SUITE 100 ATTN CREDENTIALING",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980574970",
            "telephone_number": "425-690-2715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 TALBOT RD S STE 420",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555791",
            "telephone_number": "425-690-3401",
            "fax_number": "425-690-9401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAN",
        "first_name": "PHILLIP",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "M.D.,",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "WA",
            "license": "MD60513550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2041674",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE W VALLEY MEDICAL GROUP - RENTON",
            "identifier": "G8936797",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allison E Dawood, PT
• Jaime Dawson, LMHC
• Garret G. De Castro, MD
• Betsy R De la Rosa, M.A., CFY-SLP
• Lisa Dean
• Samuel Deane, PHARMD
• Trinity Deanknox
• Debique Healing Collective
• Lindsey Decker, PTA
• Dee'S Adult Family Home L.L.C

• Colon & Rectal Surgery Physician in Renton, WA
• Providers in Renton, WA by specialty
• Colon & Rectal Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.