SPRINGBROOK UROLOGIC ASSOCIATES, INC (NPI# 1235199720) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235199720 |
| Entity Type | Organization |
| Organization Name | SPRINGBROOK UROLOGIC ASSOCIATES, INC |
| Practice Address |
4011 Talbot Rd S Renton WA 98055-5791 |
| Practice Telephone | 4252513455 |
| Practice Fax Number | 4256565002 |
| Mailing Telephone | 4252513455 |
| Mailing Fax Number | 4256565002 |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. GUY V BUELL (PRESIDENT) |
| Authorized Official Telephone | 4252513455 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 16560 | WA | Allopathic & Osteopathic Physicians |
| Street Address |
4011 TALBOT RD S |
| City | RENTON |
| State | WA |
| Zip Code | 98055-5791 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528061694 | Guy V Buell | Specialist | 4011 Talbot Rd S, Ste 440, Renton, WA 98055-5791 | 2005-05-23 |
| 1649756883 | Amy Elizabeth Hardiman | Physical Therapy Assistant | 4011 Talbot Rd S, Renton, WA 98055-5773 | 2018-07-11 |
| 1336665959 | Mary Elizabeth Walton | Dietitian, Registered | 4011 Talbot Rd S, Renton, WA 98055-5773 | 2017-08-15 |
| 1548791924 | Southlake Select, PC | Point of Service | 4011 Talbot Rd S, 440, Renton, WA 98055-5773 | 2017-03-27 |
| 1871031864 | Abrey Lee | Dietitian, Registered | 4011 Talbot Rd S, Suite 100, Renton, WA 98055-5773 | 2017-02-09 |
| 1962940957 | Kimberly Diana Konczak | Dietitian, Registered | 4011 Talbot Rd S, Suite 100, Renton, WA 98055-5773 | 2017-02-09 |
| 1578931325 | Andrew S Huntley | Physician Assistant | 4011 Talbot Rd S, Suite 300, Renton, WA 98055-5773 | 2015-09-10 |
| 1285011080 | Anne Macleod | Registered Nurse | 4011 Talbot Rd S, Renton, WA 98055-5773 | 2015-04-30 |
| 1508263716 | Mie Hagiwara | Physician Assistant | 4011 Talbot Rd S, Suite 300, Renton, WA 98055-5773 | 2014-12-03 |
| 1073921813 | Zachary A. Bowman | Physician Assistant | 4011 Talbot Rd S, Suite 300, Renton, WA 98055-5773 | 2014-07-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356965750 | Proliance Surgery Center At Valley, LLC | Clinic/Center | 4009 Talbot Road S, Suite 200, Renton, WA 98055 | 2020-06-01 |
| 1851804959 | Talbot Rehabilitation Center, LLC | Skilled Nursing Facility | 4430 Talbot Road South, Renton, WA 98055 | 2017-11-10 |
| 1154878668 | Nelson Family Dentistry | Dentist | 19221 108th Ave Se Suite #2, Renton, WA 98055 | 2016-09-01 |
| 1598182990 | Annie Kyunga Ahn | Otolaryngology | 4033 Talbot Rd S Ste 540, Renton, WA 98055 | 2014-03-24 |
| 1376960138 | Madhuri Gordhan Patel | Registered Nurse | 3501 Mill Place South, Renton, WA 98055 | 2014-03-18 |
| 1912331042 | Karen Dohr | Pharmacist | 400 S. 43 Street, Renton, WA 98055 | 2013-08-26 |
| 1659637668 | Benjamin Reiss | Ophthalmology | 4300 Talbot Rd S Ste 300, Renton, WA 98055 | 2012-04-03 |
| 1205137940 | Duy Ai Quang Hoang | Pharmacist | 9431 S 196th Pl, Renton, WA 98055 | 2010-11-11 |
| 1972823664 | Erica L Ellzey | Physical Therapist | 18623 112th Ave Se, Renton, WA 98055 | 2010-06-04 |
| 1588984587 | Melissa A. Jordan | Nurse Anesthetist, Certified Registered | 4011 Talbot Rd., 5th Floor, Renton, WA 98055 | 2010-06-02 |
| Find all providers in zip 98055 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790715100 | Rahul A Desai | Urology | 4033 Talbot Rd S Ste 500, Renton, WA 98055-5704 | 2006-07-03 |
| 1588634935 | Jeff Cooper | Urology | 4300 Talbot Road S, Suite 104, Renton, WA 98055-5767 | 2006-01-26 |
| 1861783912 | Shan Dong | Urology | 4033 Talbot Rd S Ste 500, Renton, WA 98055-5704 | 2011-04-25 |
| 1619289667 | Marcus R Kauffman, M.d., Pllc | Urology | 4300 Talbot Rd S, Suite 104, Renton, WA 98055-6238 | 2010-07-07 |
| 1619135738 | Daniel R Simon | Urology | 4033 Talbot Rd S, Ste 560, Renton, WA 98055-5772 | 2008-05-27 |
| 1578768255 | Atreya Dash | Urology | 4033 Talbot Rd S, Ste 560, Renton, WA 98055-5772 | 2007-06-20 |
| 1275673956 | Jeff Cooper Do Pllc | Urology | 4300 Talbot Road S, Suite 104, Renton, WA 98055-5767 | 2007-02-08 |
| 1831201326 | Marcus Roberts Kauffman | Urology | 4300 Talbot Road S, Suite 104, Renton, WA 98055-5767 | 2006-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295371532 | Jeffrey Allen Zhan | Urology | Good Samaritan Medical Office Bldg 1450 5th St Se, Suite 2100- Urology Clinic, Puyallup, WA 98372 | 2019-11-21 |
| 1023400041 | Pacific Northwest Urology Specialists, Pllc | Urology | 4545 Cordata Pkwy Ste 1a, Bellingham, WA 98226-7264 | 2015-02-27 |
| 1598182818 | Boston Medical Group- Washington, P.C. | Urology | 12301 N.e. 10th Place, Suite 101, Bellevue, WA 98005 | 2014-03-25 |
| 1033552823 | Carol Collins | Urology | 272 Health Sciences, 1959 Ne Pacific St, Seattle, WA 98195-7610 | 2013-04-10 |
| 1740523158 | Kacey Helena Provenzano | Urology | 780 Swift Blvd Ste 201, Richland, WA 99352 | 2013-04-03 |
| 1023366283 | William P Griggs | Urology | 2160 Dellesta Dr, Bellingham, WA 98226-7850 | 2012-08-20 |
| 1710242714 | Ralph Vernon Stagner | Urology | 3414 Horsehead Bay Dr. N.w., Gig Harbor, WA 98335 | 2012-07-06 |
| 1043579980 | Richard Kenneth Ohme | Urology | 3108 E Bay Dr Nw, Gig Harbor, WA 98335-7610 | 2012-05-13 |
| 1730447731 | Daniel Christian Sackman | Urology | 3124 South 19th St #c320, Tacoma, WA 98405-3011 | 2012-04-26 |
| 1144595299 | Philip Clark May | Urology | 11911 Ne 132nd St Ste 200, Kirkland, WA 98034 | 2012-03-21 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.