CARL GANNON PA
NPI 1053668335
Nurse Practitioner - Family in Everett, WA

Active since August 06, 2012PECOS EnrolledAccepts Medicare Assignment
12800 BOTHELL EVERETT HWY, EVERETT, WA 98208(425) 316-5180 Get Directions Write a Review

NPPES record last updated: May 20, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 20, 2021, Dec 30, 2016 (2 updates tracked since 2016).

About Carl Gannon Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CARL GANNON PA (NPI 1053668335) is an individual family provider in Everett, Washington, licensed in Washington (AP60628896) and active in the NPI registry since August 2012. He is enrolled in Medicare PECOS, is affiliated with Providence Regional Medical Center Everett, and is a graduate of Other (2004).

NPPES Registry Identity

NPI1053668335
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameCARL GANNONCredential: PA
Location Address12800 BOTHELL EVERETT HWYEverett, WA 98208-6642
Mailing AddressPo Box 3360Portland, OR 97208-3360
Sole ProprietorNo
Medical School CMSOtherGraduated 2004
Enumeration DateAugust 6, 2012
Last NPPES UpdateMay 20, 20212 updates tracked since enumeration
NPPES CertifiedMay 20, 2021
NPI 1053668335 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Licenses Licensed in WA · AP60628896 Licensed in CA · 22998
Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License 22398 (CA)
12800 BOTHELL EVERETT HWY, Everett, WA 98208

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Carl Gannon Pa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8729228531
PECOS Enrollment IDI20160714000477
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
150 services83 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
33 services33 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
22 services22 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
18 services18 patients
Assessment of emotional or behavioral problems 96127
Assessment of emotional or behavioral problems involves a thorough evaluation of your feelings, thoughts, and behaviors. It's a process where professionals study patterns over time to identify potential issues like anxiety, depression, or other mental health conditions.
11 services11 patients
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438
An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.
11 services11 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Providence Regional Medical Center Everett

Acute Care Hospitals · Everett, WA
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number500014
Location1321 Colby AvenueEverett, WA 98201 · Snohomish County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98208 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.29 typical visit price
range $57.27 – $172.80
Typical copayment $22.07 (range $14.31 – $43.20)
Most-billed visit code 99203
Established Patient
$100.78 typical visit price
range $18.56 – $141.11
Typical copayment $25.19 (range $4.64 – $35.27)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Otolaryngology
12800 BOTHELL EVERETT HWY
EVERETT, WA 98208
General Practice
12800 BOTHELL EVERETT HWY, SUITE 120
EVERETT, WA 98208
Internal Medicine
12800 BOTHELL EVERETT HWY, SUITE 180
EVERETT, WA 98208
Nurse Practitioner
12800 BOTHELL EVERETT HWY
EVERETT, WA 98208
Family Medicine
12800 BOTHELL EVERETT HWY, SUITE 160
EVERETT, WA 98208
Otolaryngology
12800 BOTHELL EVERETT HWY, SUITE 110
EVERETT, WA 98208
Physician Assistant
12800 BOTHELL EVERETT HWY, STE A
EVERETT, WA 98208
Internal Medicine
12800 BOTHELL EVERETT HWY, SUITE 120
EVERETT, WA 98208

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Carl Gannon's NPI number?

The NPI number for Carl Gannon is 1053668335. It was assigned to this individual provider in the NPPES registry on August 6, 2012.

Where is Carl Gannon located?

Carl Gannon practices at 12800 Bothell Everett Hwy, Everett, WA 98208. The listed phone number is (425) 316-5180.

What is Carl Gannon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Carl Gannon enrolled in Medicare?

Yes. Carl Gannon is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Carl Gannon accept?

Health plans from Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Carl Gannon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Carl Gannon affiliated with any hospitals?

According to CMS data, Carl Gannon is affiliated with Providence Regional Medical Center Everett.

When was this NPI record last updated?

The NPPES record for Carl Gannon was last updated on May 20, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.