Individual provider Active NPI

Sundance L Rogers, MD

  • Internal Medicine Physician
  • Bainbridge Island, WA
National Provider Identifier
1972696912
Registry record updated Jul 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD00033047 Issued in WA
Practice address
1344 Wintergreen LN NE
Bainbridge Island, WA 98110
Phone
(206) 842-5632
Fax
(206) 842-5992
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD00033047 WA Primary

Addresses

Primary practice location

1344 Wintergreen LN NE
Bainbridge Island, WA 98110

Mailing address

1344 Wintergreen LN NE
Bainbridge Island, WA 98110-5118
Phone (206) 842-5632

Other practice location 1

380 Winslow Way E
Bainbridge Island, WA 98110-2424
Phone (206) 842-5631

Other identifiers 6

IdentifierTypeStateIssuer
6701ROOtherWABLUE SHIELD #
8192486MedicaidWA
US0900037OtherWAAETNA PCP PIN
0039581OtherWALABOR AND INDUSTRIES #
US0819159OtherWAAETNA SPECIALIST PIN
110217394OtherWARAILROAD MEDICARE

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
I20041026000659 WA Practitioner - Internal Medicine 0042271660 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Florida College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virginia Mason Medical CenterGroup PAC ID 9830002617, 867 clinicians
Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

1100 9TH Ave
Seattle, WA 98101-2756
Phone (206) 223-6600

1344 Wintergreen LN NE
Bainbridge Island, WA 98110-5118
Phone (206) 842-5632

19116 33Rd Ave W
Lynnwood, WA 98036-4706
Phone (425) 712-7900

2600 Compass Rd
Glenview, IL 60026-8001

33501 1St Way S
Federal Way, WA 98003-6208
Phone (253) 838-2400

380 Winslow Way E
Bainbridge Island, WA 98110-2424
Phone (206) 842-5632

4575 Sand Point Way NE
Suite 108
Seattle, WA 98105-3999
Phone (206) 525-8000

925 Seneca St
Seattle, WA 98101-2742
Phone (206) 223-6600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00033047WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Mason Medical Center Internal Medicine Current Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center CurrentSince Jun 1, 1998 Accepting new patients
Virginia Mason Medical Center Internal Medicine CurrentSince Jun 1, 1998 Accepting new patients
Virginia Mason Medical Center Past Accepting new patients

Locations

380 Winslow Way E
Bainbridge Island, WA 98110
Phone (206) 842-5632

1344 Wintergreen Ln NE
Bainbridge Island, WA 98110
Phone (206) 842-5632

925 Seneca St
Seattle, WA 98101
Phone (206) 341-0860

4575 Sand Point Way NE
Ste 108
Seattle, WA 98105
Phone (206) 525-8000

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/66ad9a50-d7f7-4c21-b933-2ba90047388e/
  • Direct secure messaging: sundance.rogers@direct.vmmc.org

Organizations & group practices 6

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.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530489600000",
    "number": "1972696912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1344 WINTERGREEN LN NE",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981105118",
            "telephone_number": "206-842-5632",
            "fax_number": "206-842-5992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1344 WINTERGREEN LN NE",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "98110",
            "telephone_number": "206-842-5632",
            "fax_number": "206-842-5992"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "380 Winslow Way E",
            "address_purpose": "LOCATION",
            "city": "Bainbridge Island",
            "state": "WA",
            "postal_code": "981102424",
            "country_code": "US",
            "telephone_number": "206-842-5631",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "SUNDANCE",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2018-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00033047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD #",
            "identifier": "6701RO",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8192486",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PCP PIN",
            "identifier": "US0900037",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES #",
            "identifier": "0039581",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA SPECIALIST PIN",
            "identifier": "US0819159",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110217394",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bainbridge Island, WA

Sources for this page

Verify at the official NPI Registry.