Individual provider Active NPI

Mariya Yuryevna Surma

  • Family Nurse Practitioner
  • Vancouver, WA
National Provider Identifier
1982936365
Registry record updated Feb 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP30007994 Issued in WA
Practice address
7410 Delaware LN
Vancouver, WA 98664-1408
Phone
(360) 896-5128
Fax
(360) 896-5179
NPI assigned
Feb 9, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP30007994 WA Primary

Addresses

Primary practice location

7410 Delaware LN
Vancouver, WA 98664-1408

Mailing address

PO Box 34703
Seattle, WA 98124-1703
Phone (206) 764-3335

Other names 1

  • Mariya Yuryevna Didyk Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100528000540 WA Practitioner - Nurse Practitioner 9638208663 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Salmon Creek HospitalGroup PAC ID 0446295711, 309 clinicians

Practice addresses (Care Compare)

2121 NE 139TH St
Vancouver, WA 98686-2316

2211 NE 139TH St
Vancouver, WA 98686-2742
Phone 3604871000360487

Hospital & facility affiliations

  • Legacy Salmon Creek Medical Center Hospital, Vancouver, WA, CCN 500150

Merit-based Incentive Payment System (MIPS)

Final score
92.83 of 100Reported as group
Quality
96.26
Promoting interoperability
100
Improvement activities
40
Cost
79.84

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP30007994WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Salmon Creek Hospital CurrentSince Apr 1, 2013 Accepting new patients
Legacy Salmon Creek Hospital CurrentSince Apr 1, 2013 Accepting new patients

Locations

2121 NE 139th St
Ste 380
Vancouver, WA 98686
Phone (503) 413-6862

2211 NE 139th St
Vancouver, WA 98686
Phone (360) 397-1985

2101 NE 139th St
Ste 260
Vancouver, WA 98686
Phone (360) 487-2870

Interoperability endpoints

  • Direct secure messaging: msurma21227@direct.lhs.org

Organizations & group practices 2

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 2

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": "1265673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265673600000",
    "number": "1982936365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34703",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241703",
            "telephone_number": "206-764-3335",
            "fax_number": "206-764-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7410 DELAWARE LN",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986641408",
            "telephone_number": "360-896-5128",
            "fax_number": "360-896-5179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURMA",
        "first_name": "MARIYA",
        "middle_name": "YURYEVNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-09",
        "last_updated": "2010-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30007994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIYA",
            "last_name": "DIDYK",
            "middle_name": "YURYEVNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.