Unknown Individual – Family Medicine Physician, NPI 1043771942
Family Medicine Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
4,141 FAMILY PRACTICE in WA
Loading map...
Provider Addresses for Unknown Individual
1936 COLONY PL
ANCHORAGE, AK 995075394
Phone: (206) 696-4566
Type: Mailing
HealthPoint Auburn North, 923, Auburn Way North, Downtown, Auburn, King County, Washington, 98002, United States
AUBURN, WA 980024117
Phone: (253) 351-3900
Type: Location
907 Georgiana St
Port Angeles, WA 983623911
Phone: (360) 565-0999
Type: Location
907 GEORGIANA ST
PORT ANGELES, WA 983623911
Phone: (360) 565-0999
Type: Location
1902 A ST SE APT C308
AUBURN, WA 980026683
Phone: (206) 696-5666
Type: Mailing
26004 104TH AVE SE
KENT, WA 980307677
Phone: (800) 422-2844
Fax: (877) 514-9952
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20221018002505 | I | Family Practice | WA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 573 | 338 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 93 | 81 | $0 |
Insurance plans in this area (ZIP 99507)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | WA | |
| Nurse Practitioner | WA | |
| Physician Assistant | OR | |
| Physician Assistant | OR | |
| Family Practice | OR | |
| Physician Assistant | WA | |
| Family Practice | WA | |
| Nurse Practitioner | ID | |
| Nurse Practitioner | OR |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.