CONCERTO MEDICAL GROUP OF WASHINGTON, P.C. (NPI# 1568746345) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568746345 |
| Entity Type | Organization |
| Organization Name | CONCERTO MEDICAL GROUP OF WASHINGTON, P.C. |
| Other Organization Name | FIDELIS SENIOR CARE, INC.; FIDELIS SECURE HOME |
| Practice Address |
1412 Sw 43rd Street Ste 315 Renton WA 98057 |
| Practice Telephone | 4252724600 |
| Mailing Telephone | 4252724600 |
| Enumeration Date | 2011-09-28 |
| Last Update Date | 2015-08-12 |
| Authorized Official Name | MS. CINDY RITA BECKER (SECRETARY) |
| Authorized Official Telephone | 9493988413 |
| Authorized Official Credential | ESQ. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Fidelis Senior Care, Inc.; Fidelis Secure Home | Former Legal Business Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | CONCERTO MEDICAL GROUP OF WASHINGTON, P.C. | 85 Enterprise, Suite 200, Aliso Viejo, CA 92656 |
| Street Address |
1412 SW 43RD STREET STE 315 |
| City | RENTON |
| State | WA |
| Zip Code | 98057 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043856628 | Megan Ramaiya | Student in an Organized Health Care Education/Training Program | King Count Sexual Assault & Resource Center, 200 Mill Ave S # 10, Renton, WA 98057 | 2019-11-19 |
| 1063076255 | Breanne Michele Smiley | Specialist/Technologist | 737 Logan Ave N, Renton, WA 98057 | 2019-04-24 |
| 1093215063 | Laura Lewis | Physical Medicine & Rehabilitation | 1000 Oakesdale Ave Sw Ste 100, Renton, WA 98057 | 2018-02-16 |
| 1437676004 | Ralph William Papke Jr. | Counselor | Kaiser Permanente of Wa, 1200 Sw 27th St, Renton, WA 98057 | 2017-08-24 |
| 1487106456 | Serengeti Care Partners LLC | Community/Behavioral Health | 707 S- Grady Way, Suite 6008, Renton, WA 98057 | 2016-10-26 |
| 1548716152 | Phandinh Ngoc Nguyen | Naturopath | 330 Sw 43rd St,suite L, Renton, WA 98057 | 2016-09-01 |
| 1275905721 | Todd R Glass | Chiropractor | 1024 N 10th Pl #2306, Renton, WA 98057 | 2015-10-23 |
| 1134595341 | Have A Heart | Case Management | 151 Taylor Ave Nw, Renton, WA 98057 | 2015-08-12 |
| 1780087171 | Brianne N Lefferts | Physical Therapist | 300 Sw 7th Street, Renton, WA 98057 | 2014-09-30 |
| 1588089460 | Sound Association Western Washington LLC | Audiologist | 108 Factory Ave. N., Ste 2b, Renton, WA 98057 | 2014-02-28 |
| Find all providers in zip 98057 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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|---|---|---|---|---|
| 1093963795 | Stacey L. Hiles, M.d., Pllc | Clinic/Center | 17900 Talbot Rd S, Suite 101, Renton, WA 98055-8212 | 2008-09-05 |
| 1356541882 | Children First Pediatrics, Pllc | Clinic/Center | 4361 Talbot Rd S, Suite 103, Renton, WA 98055-6226 | 2007-07-23 |
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| 1013550987 | Rejuventa Medical Corp. | Clinic/Center | 107 North Tower Ave Suite 17, Centralia, WA 98531-4253 | 2019-10-23 |
| 1023668407 | Vera Whole Health Wa, PC | Clinic/Center | 4933 Evergreen Way, Everett, WA 98203-2828 | 2019-09-17 |
| 1679042501 | Family and Wellness Medicine | Clinic/Center | 34004 16th Ave S Ste 100, Federal Way, WA 98003-8905 | 2018-11-20 |
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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.