PACIFIC SURGERY CENTER
NPI 1962402503
Clinic/Center - Ambulatory Surgical in Poulsbo, WA

NPI Status: Active since July 26, 2005

Contact Information

20669 BOND RD NE
SUITE 200
POULSBO, WA
ZIP 98370
Phone: (360) 779-6527
Fax: (360) 697-2743

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • Accepts Insurance
  • CLIA Number: 50D0635394
  • CLIA Cert. Type: Ambulatory Surgery Center
  • CLIA Exp. Date: 04-04-2028

About PACIFIC SURGERY CENTER

This page provides the complete NPI Profile along with additional information for Pacific Surgery Center, a provider established in Poulsbo, Washington operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1962402503 assigned on July 2005. The practitioner's primary taxonomy code is 261QA1903X with license number 600558138 (WA). The provider is registered as an organization and their NPI record was last updated 4 years ago. The provider's is doing business as Pacific Surgery Center. The authorized official of this NPI record is Jamie Fowler (Chief Administrative Officer)

NPI
1962402503
Provider Legal Name
NORTH KITSAP AMBULATORY SURGERY CENTER, LLC
Other Organization Name
PACIFIC SURGERY CENTER
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
20669 BOND RD NE SUITE 200 POULSBO, WA 98370
Location Phone
(360) 779-6527
Location Fax
(360) 697-2743
Mailing Address
20669 BOND RD NE SUITE 200 POULSBO, WA 98370
Mailing Phone
(360) 779-6527
Mailing Fax
(360) 697-2743
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-26-2005
Last Update Date
12-28-2021
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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

Clinic/Center Ambulatory Surgical

Taxonomy Code
261QA1903X
Type
Ambulatory Health Care Facilities
License No.
600558138
License State
WA

Insurance Plans Accepted

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

  • 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 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
  • 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

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

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

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JAMIE FOWLER

Authorized Official Title
CHIEF ADMINISTRATIVE OFFICER
Authorized Official Phone
(360) 779-6527

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
7009293MEDICAID (05)WA 

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.

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

This service was performed 48 times for 48 patients

Biopsy of large bowel using a flexible endoscope

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

This service was performed 138 times for 138 patients

Colorectal cancer screening; colonoscopy on individual at high risk

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

This service was performed 30 times for 30 patients

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk

Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.

This service was performed 21 times for 20 patients

Complex removal of cataract with insertion of prosthetic lens

This procedure involves removing a cloudy lens (cataract) from your eye and replacing it with a clear, artificial lens. It helps restore vision that has been affected by the cataract. The operation is usually done under local anesthesia.

This service was performed 44 times for 37 patients

Control of bleeding of nose using an endoscope

This is a procedure where an endoscope, a thin tube with a light and camera, is used to view inside your nose. This allows the doctor to locate the source of the bleeding and control it, often by cauterization or packing the nose.

This service was performed 11 times for 11 patients

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint

This procedure involves using imaging guidance to accurately target and destroy nerves in the lower or sacral spinal facet joint. It's done to relieve chronic back pain. The process is safe and usually effective.

This service was performed 175 times for 85 patients

Destruction of surface soft tissue of nasal passages

This procedure involves removing or destroying soft tissue in the nasal passages. It's often performed to improve breathing, reduce snoring, or treat conditions like nasal polyps. The process is usually done under local or general anesthesia.

This service was performed 17 times for 17 patients

Destruction of upper or middle spinal facet joint nerves using imaging guidance, single facet joint

This procedure involves the use of imaging technology to guide a needle to the nerves of a single facet joint in the upper or middle spine. The nerves are then treated to alleviate pain and improve mobility.

This service was performed 51 times for 33 patients

Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye

This is a two-part eye procedure. First, a cloudy lens (cataract) is removed from its outer layer and replaced with an artificial lens to improve vision. Second, a drainage device is inserted into the front part of the eye to manage fluid levels, preventing pressure build-up.

This service was performed 62 times for 35 patients

Incision of eardrum with placement of eardrum tube under general anesthesia

This procedure involves making a small cut in the eardrum to drain fluid and alleviate pressure. A tiny tube is then inserted to keep the hole open and prevent further fluid buildup. General anesthesia is used to ensure patient comfort.

This service was performed 47 times for 34 patients

Incision to improve eye fluid flow

This procedure, known as a trabeculectomy, involves creating a small opening in the eye to improve fluid flow. This can help lower eye pressure in conditions like glaucoma. It's a common, safe procedure to protect your eye health.

This service was performed 41 times for 24 patients

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level

This procedure involves injecting a mix of numbing and anti-inflammatory medication into a specific nerve root in the lower back. It helps manage pain and reduce inflammation. The process is guided by imaging technology for precision.

This service was performed 124 times for 77 patients

Injection of biodegradable material next to prostate

This procedure involves the introduction of a biodegradable substance near a gland located in the lower abdomen. This substance helps to create a barrier between the gland and nearby tissues, aiding in the precise delivery of treatment to the intended area.

This service was performed 27 times for 27 patients

Injection of substance into lower spine canal using imaging guidance

This procedure involves injecting a substance into your lower spine canal, guided by real-time images. It's done to diagnose or treat various conditions. You may feel slight discomfort, but it's generally safe and can provide valuable information for your treatment plan.

This service was performed 32 times for 30 patients

Injection of substance into middle or upper spine canal using imaging guidance

This procedure involves injecting a substance into your middle or upper spine canal. It's performed under imaging guidance to ensure accuracy. The substance can help diagnose or treat various conditions, providing relief from symptoms.

This service was performed 34 times for 23 patients

Insertion of spinal neurostimulator electrode array through skin

This procedure involves placing a small device, called a neurostimulator electrode array, under your skin near your spine. It delivers mild electrical signals to your spinal cord, helping to manage chronic pain.

This service was performed 97 times for 36 patients

Insertion of spinal neurostimulator generator or receiver

The insertion of a spinal neurostimulator generator or receiver is a procedure to manage chronic pain. A small device is implanted under your skin, which sends mild electrical signals to your spinal cord. These signals disrupt pain signals, helping to reduce discomfort.

This service was performed 37 times for 36 patients

Needle biopsy of prostate gland using image guidance

A needle biopsy of the prostate gland using image guidance is a procedure where a small sample of tissue is collected for testing. This is done with the help of images to ensure precision. It helps doctors diagnose and treat potential health issues.

This service was performed 18 times for 18 patients

Placement of device in prostate for radiation therapy

This procedure involves placing a small device in the gland below the bladder to deliver radiation therapy. This helps target therapy directly to the concerned area, potentially reducing side effects and improving treatment effectiveness.

This service was performed 27 times for 27 patients

Removal of cataract with insertion of prosthetic lens

This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.

This service was performed 1,083 times for 642 patients

Removal of nasal air passage under lining tissue

This procedure, often done to improve breathing or address sinus issues, involves the removal of tissue from the lining of the nasal air passage. It's performed under anesthesia and recovery time varies based on individual health status.

This service was performed 34 times for 17 patients

Removal of nasal sinus tissue using an endoscope

This procedure, known as endoscopic sinus surgery, involves using a thin, flexible tube with a light and camera to view and remove problematic nasal sinus tissue. It helps to alleviate sinus issues and improve breathing.

This service was performed 32 times for 20 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

This service was performed 148 times for 148 patients

Removal or revision of neurostimulator generator or receiver

The procedure involves the removal or revision of a neurostimulator generator or receiver, a device implanted under the skin to send electrical pulses to the brain or spinal cord. This helps manage chronic pain or neurological disorders. The procedure might be needed if the device malfunctions, or to replace its battery.

This service was performed 14 times for 13 patients

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

This procedure involves repairing a wound on the eyelids, nose, ears, or lips by moving a small piece of skin (10.0 sq cm or less) from one area to another. The goal is to heal the wound and restore the function and appearance of the affected area.

This service was performed 14 times for 14 patients

Reshaping of nasal cartilage

Reshaping of nasal cartilage, also known as rhinoplasty, is a surgical procedure to modify the structure of the nose for aesthetic or functional purposes. It involves adjusting the cartilage and bone in the nose to achieve the desired shape or to improve breathing.

This service was performed 29 times for 29 patients

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
50D0635394
Facility Type
Ambulatory Surgery Center
Certificate Effective Date
August 09, 2002
Certificate Expiration Date
April 04, 2028
Laboratory Director
RONALD WAYNE
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Pacific Surgery Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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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 1962402503, we treat the final digit (3) 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 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).

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
1
Doubled → 2
Pos 2
9
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
2
Unchanged
Pos 5
4
Doubled → 8
Pos 6
0
Unchanged
Pos 7
2
Doubled → 4
Pos 8
5
Unchanged
Pos 9
0
Doubled → 0
Check
3
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 6 → 12 → 3 4 → 8 2 → 4 0 → 0

Step 2: Add all digits plus the NPI constant

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

2 + 9 + 1 + 2 + 2 + 8 + 0 + 4 + 5 + 0 + 24 = 57

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

The next multiple of ten after 57 is 60. The difference is the calculated check digit.

60 - 57 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1962402503.

Other Providers at the Same Location


The following 8 providers are registered at the same or a nearby location.

Ophthalmology
20669 BOND RD NE, STE 100
POULSBO, WA 98370
Ophthalmology
20669 BOND RD NE
POULSBO, WA 98370
Hearing Instrument Specialist
20669 BOND RD NE, STE 100
POULSBO, WA 98370
Hearing Instrument Specialist
20669 BOND RD NE, STE 100
POULSBO, WA 98370
Optometrist
20669 BOND RD NE, STE 100
POULSBO, WA 98370
Optometrist
20669 BOND RD NE, STE 100
POULSBO, WA 98370
Eyewear Supplier
20669 BOND RD NE, STE 100
POULSBO, WA 98370
Ophthalmology
20669 BOND RD NE, STE 100
POULSBO, WA 98370

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1962402503, enumerated as an "organization" on July 26, 2005.

The provider is located at 20669 BOND RD NE SUITE 200 POULSBO, WA 98370 and the phone number is (360) 779-6527.

Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.

The provider might be accepting Accepts: PacificSource Health Plans, Premera Blue Cross. Please consult your insurance carrier or call the provider to verify.