PROLIANCE SURGEONS, INC., P.S. (NPI# 1568875789) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568875789 |
| Entity Type | Organization |
| Organization Name | PROLIANCE SURGEONS, INC., P.S. |
| Other Organization Name | ORTHOPEDIC SPECIALISTS/VALLEY SPORTS MEDICINE OF POA |
| Practice Address |
4361 Talbot Rd S Suite 102 Renton WA 98055-6226 |
| Mailing Address |
805 Madison St Suite 901 Seattle WA 98104-1172 |
| Practice Telephone | 4252261180 |
| Practice Fax Number | 4252350695 |
| Mailing Telephone | 2062648100 |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2014-06-05 |
| Authorized Official Name | MR. DAVID G. FITZGERALD (CEO) |
| Authorized Official Telephone | 2068382599 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | 601484763 | WA | Allopathic & Osteopathic Physicians |
| N | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
601484763 | WA | Allopathic & Osteopathic Physicians |
| Y | 207XS0106X |
Orthopaedic Surgery Specialization: Hand Surgery |
601484763 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | MEDICARE PTAN | GAB03033 | 01 |
| Other Name | Type Code |
|---|---|
| Orthopedic Specialists/Valley Sports Medicine of POA | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902418189 | Proliance Surgeons, Inc., P.s. | Orthopaedic Surgery | 2727 Hollycroft St Ste 410, Gig Harbor, WA 98335-1369 | 2020-08-19 |
| 1790325710 | Proliance Surgeons, Inc., P.s. | Radiology | 1101 Madison St Ste 580, Seattle, WA 98104-4305 | 2020-01-07 |
| 1104474808 | Proliance Surgeons, Inc., P.s. | Durable Medical Equipment & Medical Supplies | 1231 116th Ave Ne Ste 755, Bellevue, WA 98004-3804 | 2019-08-27 |
| 1417512021 | Proliance Surgeons, Inc., P.s. | Orthopaedic Surgery | 1620 Lake Tapps Pkwy Se Ste 115, Auburn, WA 98092-8376 | 2019-05-08 |
| 1205307253 | Proliance Surgeons, Inc., P.s. | Orthopaedic Surgery | 901 Boren Ave Ste 711, Seattle, WA 98104-3301 | 2018-12-16 |
| 1972073799 | Proliance Surgeons, Inc., P.s. | Orthopaedic Surgery | 150 Andover Park W, Tukwila, WA 98188-2801 | 2018-12-05 |
| 1184106262 | Proliance Surgeons, Inc., P.s. | Orthopaedic Surgery | 18100 Ne Union Hill Rd Ste 330, Redmond, WA 98052-3330 | 2018-09-05 |
| 1184140477 | Proliance Surgeons, Inc., P.s. | Radiology | 6808 220th St Sw Ste 105, Mountlake Terrace, WA 98043-2187 | 2017-08-17 |
| 1255736971 | Proliance Surgeons, Inc., P.s. | Surgery | 1519 3rd St Se Ste 210, Puyallup, WA 98372-3742 | 2014-10-23 |
| 1467883116 | Proliance Surgeons, Inc., P.s. | Physical Medicine & Rehabilitation | 1017 20th St, Anacortes, WA 98221-2505 | 2013-12-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | PROLIANCE SURGEONS, INC., P.S. | 805 Madison St Ste 901, Seattle, WA 98104-1172 |
| Washington State Corporations | PROLIANCE SURGEONS, INC., P.S. | 805 Madison St Ste 901, Seattle, WA 98104-1172 |
| Street Address |
4361 TALBOT RD S SUITE 102 |
| City | RENTON |
| State | WA |
| Zip Code | 98055-6226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528068533 | Renton Sports & Spine Pt | Physical Therapist | 4361 Talbot Rd S, Suite 100, Renton, WA 98055-6226 | 2005-08-01 |
| 1063725505 | David P Ruoff, Md, Inc, Ps. | Orthopaedic Surgery | 4361 Talbot Rd S, Suite 102, Renton, WA 98055-6226 | 2010-07-26 |
| 1043490543 | Associated Valley Providers Pllc | Obstetrics & Gynecology | 4361 Talbot Rd S, Suite 112, Renton, WA 98055-6226 | 2007-11-13 |
| 1356541882 | Children First Pediatrics, Pllc | Clinic/Center | 4361 Talbot Rd S, Suite 103, Renton, WA 98055-6226 | 2007-07-23 |
| 1841352143 | Orit Hickman | Specialist | 4361 Talbot Rd S, Ste 100, Renton, WA 98055-6226 | 2006-12-14 |
| 1578623690 | John L Vander Heyden | Obstetrics & Gynecology | 4361 Talbot Rd S, 112, Renton, WA 98055-6226 | 2006-12-11 |
| 1336208321 | Michael Brian Vickers | Podiatrist | 4361 Talbot Rd S, 112, Renton, WA 98055-6226 | 2006-12-06 |
| 1447319330 | Mary Louise Mckevitt | Registered Nurse | 4361 Talbot Rd S, Renton, WA 98055-6226 | 2006-12-06 |
| 1063584498 | Deborah Jean Ketterer | Podiatrist | 4361 Talbot Rd S, Suite 101, Renton, WA 98055-6226 | 2006-11-14 |
| 1043271927 | Steven L Summerfield | Orthopaedic Surgery | 4361 Talbot Rd S, #102, Renton, WA 98055 | 2006-03-30 |
| Find all providers in the same location | ||||
| 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 | 207XS0106X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Hand Surgery |
| An orthopaedic surgeon trained in the investigation, preservation and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104942036 | Steven L Summerfield Md Inc Ps | Orthopaedic Surgery | 4361 Talbot Rd S Ste 102, Renton, WA 98055-6226 | 2007-03-22 |
| 1043271927 | Steven L Summerfield | Orthopaedic Surgery | 4361 Talbot Rd S, #102, Renton, WA 98055 | 2006-03-30 |
| 1942271994 | Craig Thomas Arntz | Orthopaedic Surgery | 4011 Talbot Rd S, Suite 300, Renton, WA 98055-5773 | 2006-01-29 |
| 1023089075 | Traci Granston Barthel | Orthopaedic Surgery | 4011 Talbot Rd S, Suite 300, Renton, WA 98055-5773 | 2006-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326564790 | Proliance Surgeons, Inc., P.s | Orthopaedic Surgery | 6808 220th St Sw Ste 200, Mountlake Terrace, WA 98043-2187 | 2017-08-17 |
| 1689914541 | Sound Hand and Orthopedics, Pllc | Orthopaedic Surgery | 901 Boren Ave Ste 900, Seattle, WA 98104-3596 | 2013-02-28 |
| 1083831549 | Eugene Chan Farng | Orthopaedic Surgery | 4245 Roosevelt Way Ne # 354740, Seattle, WA 98105-6008 | 2007-04-19 |
| 1750450490 | Ghalib A. Husseini | Orthopaedic Surgery | 4446 Eld Ln Nw, Olympia, WA 98502-8806 | 2006-11-07 |
| 1467493890 | Northwest Hand Specialists, Inc., P.s. | Orthopaedic Surgery | 19930 Ballinger Way Ne, Shoreline, WA 98155-1223 | 2006-06-09 |
| 1437102274 | Strait Orthopedic Specialists. Ps | Orthopaedic Surgery | 832 Georgiana St, Port Angeles, WA 98362-3512 | 2006-05-19 |
| 1871574624 | John A Miyano | Orthopaedic Surgery | 600 Broadway, Suite 440, Seattle, WA 98122 | 2005-11-09 |
| 1790293173 | Bellevue Orthopedic Physicians Pllc | Orthopaedic Surgery | 1200 112th Ave Ne Ste C210, Bellevue, WA 98004 | 2018-01-19 |
| 1174036826 | Bellevue Orthopedic Physicians Pllc | Orthopaedic Surgery | 1200 112th Ave Ne Ste C210, Bellevue, WA 98004 | 2017-11-15 |
| 1376981282 | Julie Johnson Roberts | Orthopaedic Surgery | 33501 1st Way S, Federal Way, WA 98003 | 2013-06-13 |
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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.