Individual provider Active NPI

Peter Scott Dammen, PA

  • Physician Assistant
  • Renton, WA
National Provider Identifier
1972823094
Registry record updated Jun 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60582305 Issued in WA
Practice address
400 S 43Rd St
Renton, WA 98055-5714
Phone
(425) 228-3440
Fax
(425) 656-5016
NPI assigned
Jun 11, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-02344 NC
Physician Assistant 363A00000X PA60582305 WA Primary

Addresses

Primary practice location

400 S 43Rd St
Renton, WA 98055-5714

Mailing address

400 S 43Rd St
Renton, WA 98055-5714
Phone (425) 228-3440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100717000024 NC Practitioner - Physician Assistant 9436281037 Reassigns benefits to 1 organization
I20151118003090 WA Practitioner - Physician Assistant 9436281037 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wake Emergency Physicians PAGroup PAC ID 9931002078, 269 clinicians

Practice addresses (Care Compare)

509 N Brightleaf Blvd
Smithfield, NC 27577-4407
Phone (919) 934-8171

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
96.2
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-02344NCMDPhysician Assistant
PA60582305WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Emergency Physicians PA CurrentSince Nov 1, 2025 Accepting new patients
Wake Emergency Physicians PA CurrentSince Nov 1, 2025 Accepting new patients
Wake Forest University Health Sciences Past Accepting new patients
Wake Forest University Health Sciences Past Accepting new patients

Locations

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

509 N Brightleaf Blvd
Smithfield, NC 27577
Phone (919) 934-8171

Organizations & group practices 5

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": "1276214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561420800000",
    "number": "1972823094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S 43RD ST",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555714",
            "telephone_number": "425-228-3440",
            "fax_number": "425-656-5016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S 43RD ST",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555714",
            "telephone_number": "425-228-3440",
            "fax_number": "425-656-5016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAMMEN",
        "first_name": "PETER",
        "middle_name": "SCOTT",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-11",
        "last_updated": "2019-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-02344",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60582305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.