Individual provider Active NPI

William S. Waites, PA-C

  • Physician Assistant
  • Kennewick, WA
National Provider Identifier
1992970297
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10003522 Issued in WA
Practice address
3730 Plaza Way Ste C6100
Kennewick, WA 99338-2718
Phone
(509) 591-0070
Fax
(509) 396-9661
NPI assigned
Apr 28, 2008
Last updated
Jan 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10003522 WA Primary

Addresses

Primary practice location

3730 Plaza Way Ste C6100
Kennewick, WA 99338-2718

Mailing address

8524 W Gage Blvd
BLDG a-1 Box 319
Kennewick, WA 99336-8241
Phone (509) 591-0070

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
I20080717000074 WA Practitioner - Physician Assistant 1951474493 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Immediate Care and Medical Centers PSGroup PAC ID 7618865775, 19 clinicians

Practice addresses (Care Compare)

1215 George Washington Way
Richland, WA 99352-3411
Phone (509) 946-1695

1516 Jadwin Ave
Richland, WA 99354-2902
Phone (509) 946-1695

1601 N Division St
Suite a
Spokane, WA 99207-2427
Phone (509) 824-6080

3601 Plaza Way
Kennewick, WA 99338-2716
Phone (509) 236-0391

705 Gage Blvd
Suite 200
Richland, WA 99352-9716
Phone (509) 824-6080

Merit-based Incentive Payment System (MIPS)

Final score
78.88 of 100Reported as group
Quality
44.55
Improvement activities
40
Cost
76.54

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA10003522WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Restore Health & Pain Treatment Group PLLC CurrentSince Nov 5, 2023 Accepting new patients
Tran Urgent Care & Wellness Centers LLC Past Accepting new patients
Pinnicale Pain Center Medical PastSince Sep 25, 2019 Accepting new patients
Our Lady of Lourdes Health Center Past Accepting new patients
Lourdes Hospital LLC Past Accepting new patients
Moses Lake Community Health Center Past Accepting new patients

Locations

705 Gage Blvd
Ste 200
Richland, WA 99352
Phone (509) 628-2331

1601 N Division St
Ste A
Spokane, WA 99207
Phone (509) 824-6080

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21373/brand/1/csg/1/fhir/r4

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1992970297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8524 W GAGE BLVD",
            "address_2": "BLDG A-1 BOX 319",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993368241",
            "telephone_number": "509-591-0070",
            "fax_number": "509-396-9661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3730 PLAZA WAY STE C6100",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993382718",
            "telephone_number": "509-591-0070",
            "fax_number": "509-396-9661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAITES",
        "first_name": "WILLIAM",
        "middle_name": "S.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-28",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10003522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennewick, WA

Sources for this page

Verify at the official NPI Registry.