KENNETH MURRAY EDSTROM MD - NPI 1649373663 - Obstetrics & Gynecology in Puyallup, WA

Q: What is Kenneth Edstrom's NPI number?

The NPI number for Kenneth Edstrom is 1649373663. It was assigned to this individual provider in the NPPES registry on September 6, 2006.

Q: What is Kenneth Edstrom's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Q: When was this NPI record last updated?

The NPPES record for Kenneth Edstrom was last updated on June 15, 2012. NPI Profile syncs with the weekly NPPES data releases published by CMS.

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About Kenneth Murray Edstrom Md NPPES

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

KENNETH MURRAY EDSTROM MD (NPI 1649373663) is an individual obstetrics & gynecology provider in Puyallup, Washington, licensed in Washington (MD00026074) and active in the NPI registry since September 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1649373663

Entity TypeIndividualMale

Primary Taxonomy207V00000X

Provider Legal NameKENNETH MURRAY EDSTROMCredential: MD

Location Address1701 3RD ST SE, SUITE 200Puyallup, WA 98372-4511

Mailing Address1701 3rd St Se, Suite 200Puyallup, WA 98372-4511 · (253) 840-4444 · Fax (253) 840-5239

Phone(253) 840-4444

Fax(253) 840-5239

Sole ProprietorNo

Enumeration DateSeptember 6, 2006

Last NPPES UpdateJune 15, 2012

✔ NPI 1649373663 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians

Taxonomy Code207V00000X

License✔ Licensed in WA · MD00026074

Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

1701 3RD ST SE, Puyallup, WA 98372

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Other Identifiers 3

Medicaid7085020WA

Medicare UPINC92565

Medicare ID-Type UnspecifiedGAB25749

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kenneth Murray Edstrom Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 98372 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

$130.99 typical visit price

range $57.27 – $172.80

Typical copayment $32.74 (range $14.31 – $43.20)

Most-billed visit code 99204

Established Patient

$71.29 typical visit price

range $18.56 – $141.11

Typical copayment $17.82 (range $4.64 – $35.27)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.