MARIA LYNN DETHERAGE (MS, RPAC) – Physician Assistant, NPI 1720219173
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
4,282 PHYSICIAN ASSISTANT in WA
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Provider Addresses for MARIA LYNN DETHERAGE (MS, RPAC)
31675 PACIFIC HWY S
FEDERAL WAY, WA 980035407
Phone: (253) 215-1093
Fax: (253) 215-1094
Type: Mailing
CityMD, 31675, Pacific Highway South, Federal Way, King County, Washington, 98003, United States
FEDERAL WAY, WA 980035407
Phone: (253) 215-1093
Fax: (253) 215-1094
Type: Location
117, Roosevelt Boulevard, City of Long Beach, Nassau County, New York, 11561, United States
LONG BEACH, NY 115613735
Phone: (516) 359-1428
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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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.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2018-12-18
PECOS data refreshed: 2026-05-27
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 |
|---|---|---|---|---|
| I20181218001882 | I | Physician Assistant | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 154 | 148 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 55 | 55 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 34 | 34 | $0 |
| 81002 | Urinalysis, manual test | 33 | 33 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 11 | 11 | $0 |
Insurance plans in this area (ZIP 98003)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | SC | |
| Physician Assistant | WA | |
| - | WA | |
| General Surgery | MI | |
| - | WA | |
| Nurse Practitioner | WA | |
| - | WI | |
| - | WA | |
| - | WA | |
| Family Practice | WA |
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