Individual provider Active NPI

Samuel Grant Osborne, AU.D.

  • Audiologist
  • Burien, WA
National Provider Identifier
1992298814
Registry record updated Aug 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
LD60871775 Issued in WA
Practice address
16259 Sylvester Rd SW Ste 505
Burien, WA 98166
Phone
(206) 242-3696
NPI assigned
Jun 14, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X LD60871775 WA Primary

Addresses

Primary practice location

16259 Sylvester Rd SW Ste 505
Burien, WA 98166

Mailing address

16259 Sylvester Rd SW Ste 505
Burien, WA 98166-3059
Phone (206) 242-3696

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181024000650 WA Practitioner - Qualified Audiologist 8123371986 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LD60871775WAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc P S CurrentSince Aug 27, 2018 Accepting new patients
Proliance Surgeons Inc P S Current Accepting new patients
Proliance Surgeons, Inc., P.S. CurrentSince Aug 27, 2018 Accepting new patients

Locations

16259 Sylvester Rd SW
Ste 505
Burien, WA 98166
Phone (206) 242-3696

16122 8th Ave SW
Ste D1
Burien, WA 98166
Phone (206) 241-7146

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

Interoperability endpoints

  • Direct secure messaging: samuel.osborne.p47@direct.proliance.nextgenshare.com

Organizations & group practices 3

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": "1528934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535068800000",
    "number": "1992298814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16259 SYLVESTER RD SW STE 505",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981663059",
            "telephone_number": "206-242-3696",
            "fax_number": "206-246-1078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16259 SYLVESTER RD SW STE 505",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "98166",
            "telephone_number": "206-242-3696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSBORNE",
        "first_name": "SAMUEL",
        "middle_name": "GRANT",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-14",
        "last_updated": "2018-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "WA",
            "license": "LD60871775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burien, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.