SEAN T MCGUIRE MD
NPI 1659647196
Dermatology - MOHS-Micrographic Surgery in Everett, WA

NPI Status: Active since March 29, 2012

Contact Information

3726 COLBY AVE
EVERETT, WA
ZIP 98201
Phone: (425) 257-1450

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
Areas of Expertise
Physician Visit Costs
Quality Reporting
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Male
Years of Experience 14
Dermatology
MOHS-Micrographic Surgery
Accepts Insurance
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting

About SEAN MCGUIRE

This page provides the complete NPI Profile along with additional information for Sean Mcguire, a provider established in Everett, Washington with a medical specialization in Dermatology, focusing in mohs-micrographic surgery and more than 14 years of experience. He graduated from University Of Pittsburgh School Of Medicine in 2012. The healthcare provider is registered in the NPI registry with number 1659647196 assigned on March 2012. The practitioner's primary taxonomy code is 207ND0101X with license number MD60845003 (WA). The provider is registered as an individual and his NPI record was last updated April 2026.

NPI: 1659647196
Provider Name: SEAN T MCGUIRE MD
Gender: Male
Entity Type: Individual
Location Address: 3726 COLBY AVE EVERETT, WA 98201
Location Phone: (425) 257-1450
Mailing Address: 7600 EVERGREEN WAY EVERETT, WA 98203
Mailing Phone: (206) 860-5414
Medical School Name: UNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE
Graduation Year: 2012
Is Sole Proprietor?: No
Enumeration Date: 03-29-2012
Last Update Date: 04-17-2026
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Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Dermatology MOHS-Micrographic Surgery
Taxonomy Code: 207ND0101X
Type: Allopathic & Osteopathic Physicians
License No.: MD60845003
License State: WA
Taxonomy Description: The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

PacificSource Health Plans

Core Bronze HSA 10600 - EPO
Core Bronze HSA 7500 - EPO
Core Bronze HSA 8300 - EPO
Core Gold 1500 - EPO
Core Gold 3000 - EPO
Core Silver 3500 - EPO
Core Silver 4500 - EPO
Core Silver 5000 - EPO
Core Silver 7500 - EPO
Core Standard Expanded Bronze HSA - EPO
Core Standard Gold - EPO
Core Standard Silver - EPO
PacificSource Oregon Standard Bronze HSA Plan Core - EPO
PacificSource Oregon Standard Gold Plan Core - EPO
PacificSource Oregon Standard Silver Plan Core - EPO

Premera Blue Cross Blue Shield of Alaska

Premera Blue Cross Alaska One Gold - PPO
Premera Blue Cross Preferred Bronze 5800 HSA - PPO
Premera Blue Cross Preferred Bronze 6350 - PPO
Premera Blue Cross Preferred Gold 1500 - PPO
Premera Blue Cross Preferred Silver 4500 - PPO
Premera Blue Cross Standard Bronze II - PPO
Premera Blue Cross Standard Gold - PPO
Premera Blue Cross Standard Silver - PPO
Premera Blue Cross Family Dental - PPO
Premera Blue Cross Pediatric Dental - PPO

Providence Health Plan

HSA-E Qualified 7500 Bronze - Signature Network - EPO
Providence Oregon Standard Bronze Plan - Signature Network - EPO
Providence Oregon Standard Gold Plan - Signature Network - EPO
Providence Oregon Standard Silver Plan - Signature Network - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Sean Mcguire is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Sean Mcguire is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
PECOS PAC ID: 840568101
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.
PECOS Enrollment ID: I20180730003389
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.
Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Bacterial culture, any other source except urine, blood or stool, aerobic
Biopsy of related skin growth, first growth
Complicated repair of wound of eyelids, nose, ears, or lip, 1.1-2.5 cm
Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm
Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 1.1-2.5 cm
Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm
Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm
Established patient office or other outpatient visit, 20-29 minutes
Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution
Full thickness skin graft to nose, ears, eyelids, or lips, 20.0 sq cm or less
Identification of organisms by immunologic analysis, other than immunofluorescence method
Injection into skin growth, 1-7 growths
Injection, triamcinolone acetonide, not otherwise specified, 10 mg
Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm
Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm
Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional
Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks
Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks
Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks
Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm
Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm
Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less
Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less
Repair of wound of scalp, arms, or legs by transferring skin, 10.1-30.0 sq cm
Special gram or giemsa stain for microorganism

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $22.07 for a new patient copayment and $17.82 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 98201 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

Average New Patient Price $88.29
Minimum New Patient Price $57.27
Maximum New Patient Price $172.8

Average New Patient Copayment $22.07
Minimum New Patient Copayment $14.31
Maximum New Patient Copayment $43.2

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

Average Established Patient Price $71.29
Minimum Established Patient Price $18.56
Maximum Established Patient Price $141.11

Average Established Patient Copayment $17.82
Minimum Established Patient Copayment $4.64
Maximum Established Patient Copayment $35.27

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure	Performance	Number of Patients
Care coordination agreements that promote improvements in patient tracking across settings	Yes	N/A
Establish effective care coordination and active referral management that could include one or more of the following: Establish care coordination agreements with frequently used consultants that set expectations for documented flow of information and MIPS eligible clinician or MIPS eligible clinician group expectations between settings. Provide patients with information that sets their expectations consistently with the care coordination agreements; Track patients referred to specialist through the entire process; and/or Systematically integrate information from referrals into the plan of care.
Documentation of Current Medications in the Medical Record	46%	1042
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration
Engagement of patients through implementation of improvements in patient portal	Yes	N/A
Access to an enhanced patient portal that provides up to date information related to relevant chronic disease health or blood pressure control, and includes interactive features allowing patients to enter health information and/or enables bidirectional communication about medication changes and adherence.
e-Prescribing	98%	773
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Implementation of medication management practice improvements	Yes	N/A
Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews.
Medication Reconciliation	0%	362
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
Patient-Specific Education	79%	1114
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Pneumococcal Vaccination Status for Older Adults	4%	191
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record	Yes	N/A
• Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management.
Provide Patient Access	79%	1114
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information.
Regular Review Practices in Place on Targeted Patient Population Needs	Yes	N/A
Implementation of regular reviews of targeted patient population needs, such as structured clinical case reviews, which includes access to reports that show unique characteristics of eligible clinician's patient population, identification of vulnerable patients, and how clinical treatment needs are being tailored, if necessary, to address unique needs and what resources in the community have been identified as additional resources.
Secure Messaging	0%	1114
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk Analysis	Yes	N/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Specialized Registry Reporting	Yes	N/A
The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI.

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1659647196, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 6).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 10 → 1 + 0

Pos 4

Unchanged

Pos 5

Doubled → 12 → 1 + 2

Pos 6

Unchanged

Pos 7

Doubled → 14 → 1 + 4

Pos 8

Unchanged

Pos 9

Doubled → 18 → 1 + 8

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 5 → 10 → 1 6 → 12 → 3 7 → 14 → 5 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 1 + 0 + 9 + 1 + 2 + 4 + 1 + 4 + 1 + 1 + 8 + 24 = 64

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 64 is 70. The difference is the calculated check digit.

70 - 64 = 6

This NPI is valid

The calculated check digit is 6, which matches the last digit of 1659647196.

Other Providers at the Same Location

The following 1 provider is registered at the same or a nearby location.

OPTUM CARE WASHINGTON PLLC

Durable Medical Equipment & Medical Supplies

3726 COLBY AVE
EVERETT, WA 98201

Snohomish County (425) 257-1450

About SEAN MCGUIRE

Location Map

Specialty - Primary Taxonomy

Dermatology MOHS-Micrographic Surgery

Insurance Plans Accepted

PacificSource Health Plans

Premera Blue Cross Blue Shield of Alaska

Providence Health Plan

Medicare Participation & PECOS Enrollment Status

Is the provider registered in PECOS? Yes

PECOS PAC ID: 840568101

PECOS Enrollment ID: I20180730003389

Accepts Medicare Assignment? Yes

Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

Eligible to Order or Refer a Home Health Agency (HHA): Yes

Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

Bacterial culture, any other source except urine, blood or stool, aerobic

Biopsy of related skin growth, first growth

Complicated repair of wound of eyelids, nose, ears, or lip, 1.1-2.5 cm

Complicated repair of wound of eyelids, nose, ears, or lip, 2.6-7.5 cm

Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 1.1-2.5 cm

Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm

Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm

Established patient office or other outpatient visit, 20-29 minutes

Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution

Full thickness skin graft to nose, ears, eyelids, or lips, 20.0 sq cm or less

Identification of organisms by immunologic analysis, other than immunofluorescence method

Injection into skin growth, 1-7 growths

Injection, triamcinolone acetonide, not otherwise specified, 10 mg

Intermediate repair of wound of neck, hands, feet, or genitals, 2.6-7.5 cm

Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm

Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional

Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks

Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks

Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks

Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm

Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm

Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less

Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less

Repair of wound of scalp, arms, or legs by transferring skin, 10.1-30.0 sq cm

Special gram or giemsa stain for microorganism

Physician Visit Costs

New Patients Visit Costs *

Established Patients Visit Costs *

Quality Reporting

Reviews for SEAN T MCGUIRE MD

NPI NPI Number Validation

How NPI Validation Works

Digit-by-digit view

Step 1: Double every other digit from the right

Step 2: Add all digits plus the NPI constant

Step 3: Find the amount needed to reach the next multiple of 10

Other Providers at the Same Location

Frequently Asked Questions

What is Sean Mcguire's NPI number?

Where is the provider located?

What is the provider's specialty?

What insurance does Sean Mcguire accept?