CHARLES IBEZIAKO MD
NPI 1093695249
Family Medicine in Othello, WA

Q: What is Charles Ibeziako's NPI number?

The NPI number for Charles Ibeziako is 1093695249. It was assigned to this individual provider in the NPPES registry on September 6, 2025.

Q: What is Charles Ibeziako's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Charles Ibeziako was last updated on September 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since September 06, 2025PECOS EnrolledAccepts Medicare Assignment

1515 E COLUMBIA ST, OTHELLO, WA 99344(509) 488-5256(509) 488-9939 Get Directions Write a Review

NPPES record last updated: September 23, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 8, 2025, Sep 6, 2025 (2 updates tracked since 2025).

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About Charles Ibeziako Md NPPES

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

CHARLES IBEZIAKO MD (NPI 1093695249) is an individual family medicine provider in Othello, Washington, licensed in Washington (ML70050698) and active in the NPI registry since September 2025. He is enrolled in Medicare PECOS, maintains a secondary practice location in Mattawa, and is a graduate of Other (1994).

NPPES Registry Identity

NPI1093695249

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameCHARLES IBEZIAKOCredential: MD

Location Address1515 E COLUMBIA STOthello, WA 99344-1846

Mailing Address1515 E Columbia StOthello, WA 99344-1846 · (509) 488-5256 · Fax (509) 488-9939

Phone(509) 488-5256

Fax(509) 488-9939

Sole ProprietorNo

Medical School CMSOtherGraduated 1994

Enumeration DateSeptember 6, 2025

Last NPPES UpdateSeptember 23, 20252 updates tracked since enumeration

NPPES CertifiedSeptember 23, 2025

✔ NPI 1093695249 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in WA · ML70050698

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1515 E COLUMBIA ST, Othello, WA 99344

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Secondary Practice Location 1

Location 1601 Government RdMattawa, WA 99349-5120 · Phone (509) 488-5256 · Fax (509) 488-9939

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

Charles Ibeziako Md 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 ID6901398692

PECOS Enrollment IDI20251120001447

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 99344 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.

LAURA ELY

Nurse Practitioner (Family)