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ADVANCED PAIN CARE PS
NPI 1114410495
Physician Assistant in Olympia, WA

Active since June 11, 2018CLIA 50D2154651 · Waiver
205 LILLY RD NE BLDG B, STE A, OLYMPIA, WA 98506(360) 218-5990(866) 308-9873 Get Directions Write a Review

NPPES record last updated: January 1, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jan 1, 2024, Jun 11, 2018 (2 updates tracked since 2018).

About Advanced Pain Care Ps NPPES

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

ADVANCED PAIN CARE PS (NPI 1114410495) is a healthcare organization registered as a physician assistant in Olympia, Washington and active in the NPI registry since June 2018. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists David Keith Naibert, Owner, as its authorized official.

NPPES Registry Identity

NPI1114410495
Entity TypeOrganization
Primary Taxonomy363A00000X
Legal Business NameADVANCED PAIN CARE PS
Location Address205 LILLY RD NE BLDG B, STE AOlympia, WA 98506
Mailing AddressDept La 24793Pasadena, CA 91185-4793
Phone(360) 218-5990
Fax(866) 308-9873
Organization SubpartYesParent: Lake Washington Private Medicine Inc
Authorized OfficialDavid Keith NaibertOwner · (206) 200-5867
Enumeration DateJune 11, 2018
Last NPPES UpdateJanuary 1, 20242 updates tracked since enumeration
NPPES CertifiedJanuary 1, 2024
✔ NPI 1114410495 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedClinic/Center · PainTaxonomy 261QP3300X
205 LILLY RD NE BLDG B, Olympia, WA 98506
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Other Names 1

Doing Business AsAdvanced Pain Care Ps

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Premera Blue Cross Blue Shield of Alaska.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Advanced Pain Care Ps is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Advanced Pain Care Ps, which bills Medicare for the services this clinician delivers.

Clinician (1)

Nickole Saulsberry, FNP-C
Nurse Practitioner
NPI 1669998910
205 LILLY RD NE BLDG B ,STE A
Olympia, WA 98506
(360) 218-5990
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 50D2154651

Advanced Pain Care · Olympia, WA
Active · expires Apr 4, 2028
CLIA Number50D2154651
Laboratory TypePhysician Office
Certificate Effective DateSeptember 17, 2018
Certificate Expiration DateApril 4, 2028
Laboratory DirectorDavid K. Naibert
Laboratory Phone(360) 218-5990
Laboratory LocationAdvanced Pain Care205 Lilly Rd NE Bldg B Ste A, Olympia, WA 98506
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Advanced Pain Care Ps's NPI number?

The NPI number for Advanced Pain Care Ps is 1114410495. It was assigned to this organization in the NPPES registry on June 11, 2018.

Where is Advanced Pain Care Ps located?

Advanced Pain Care Ps is located at 205 Lilly Rd NE Bldg B Ste A, Olympia, WA 98506. The listed phone number is (360) 218-5990.

What is Advanced Pain Care Ps's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Advanced Pain Care Ps enrolled in Medicare?

Yes. Advanced Pain Care Ps is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Advanced Pain Care Ps?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Advanced Pain Care Ps. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Advanced Pain Care Ps hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D2154651) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Advanced Pain Care Ps accept?

Health plans from Ambetter Health and Premera Blue Cross Blue Shield of Alaska list Advanced Pain Care Ps 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.

When was this NPI record last updated?

The NPPES record for Advanced Pain Care Ps was last updated on January 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.