LAKE WILDERNESS MEDICAL CLINIC LLC
NPI 1982879045
Exclusive Provider Organization in Maple Valley, WA
- Organization
- Exclusive Provider Organization
About LAKE WILDERNESS MEDICAL CLINIC LLC
This page provides the complete NPI Profile along with additional information for Lake Wilderness Medical Clinic Llc, a provider established in Maple Valley, Washington operating as a Exclusive Provider Organization. The healthcare provider is registered in the NPI registry with number 1982879045 assigned on April 2008. The practitioner's primary taxonomy code is 302F00000X with license number MD00023662 (WA). The provider is registered as an organization and their NPI record was last updated 18 years ago. The authorized official of this NPI record is Chester E Jangala Jr. Md (Physician)
- NPI
- 1982879045 Verify this NPI
- Provider Name
- LAKE WILDERNESS MEDICAL CLINIC LLC
- Entity Type
- Organization
- Location Address
- 26907 MAPLE VALLEY BLACK DIAMOND RD SE MAPLE VALLEY, WA 98038
- Location Phone
- (425) 432-9611
- Location Fax
- (206) 973-5399
- Mailing Address
- PO BOX 1142 RAVENSDALE, WA 98051
- Mailing Phone
- (425) 432-9611
- Mailing Fax
- (206) 973-5399
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 04-29-2008
- Last Update Date
- 04-29-2008
- Code Navigator
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
Exclusive Provider Organization
- Taxonomy Code
- 302F00000X
- Type
- Managed Care Organizations
- License No.
- MD00023662
- License State
- WA
- Taxonomy Description
- (1) An EPO is a form of PPO, in which patients must visit a caregiver that is specified on its panel of providers (is a participating provider). If a visit to an outside(not participating) provider is made the EPO offers very limited or no coverage for the medical service; (2) While similar to a PPO in that an EPO allows patients to go outside the network for care, if they do so in an EPO, they are required to pay the entire cost of care. An EPO differs from an HMO in that EPO physicians do not receive capitation but instead are reimbursed only for actual services provided; (3) An organization identical to a preferred provider organization except that persons enrolled in the plan are eligible to receive benefits only when they use the services of the contracting providers. No benefits are available when non-contracting providers are used, except in certain emergency situations.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
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.
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 |
|---|---|---|---|
| A06144 | MEDICARE UPIN (02) |
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Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
MAPLE VALLEY, WA 98038
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1982879045, enumerated as an "organization" on April 29, 2008.
The provider is located at 26907 MAPLE VALLEY BLACK DIAMOND RD SE MAPLE VALLEY, WA 98038 and the phone number is (425) 432-9611.
Exclusive Provider Organization with taxonomy code 302F00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
