DR. THOMAS MILAN MIRICH III (NPI# 1952327025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952327025 |
| Entity Type | Individual |
| Full Name | DR. THOMAS MILAN MIRICH III |
| Credential | MD |
| Practice Address |
611 S Chestnut St Suite D Ellensburg WA 98926-4815 |
| Practice Telephone | 5099338700 |
| Practice Fax Number | 5099338705 |
| Mailing Telephone | 5099338700 |
| Mailing Fax Number | 5099338705 |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2016-04-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 11582 | MT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE RR PTAN | P00465648 | 01 | |
| MT | 1952327025 | 05 | |
| MT | BLUE CROSS/BLUE SHIELD | 99366 | 01 |
| Street Address |
611 S CHESTNUT ST SUITE D |
| City | ELLENSBURG |
| State | WA |
| Zip Code | 98926-4815 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407819766 | Gary D Bos | Orthopaedic Surgery | 611 S Chestnut St, Ste. D, Ellensburg, WA 98926-4815 | 2006-04-08 |
| 1205140597 | Thomas M Penoyar | Surgery | 611 S Chestnut St, Ellensburg, WA 98926-4815 | 2010-07-29 |
| 1992025936 | John H Sand Md | Specialist | 611 S Chestnut St, Suite B, Ellensburg, WA 98926-4815 | 2010-06-01 |
| 1538280052 | Nancy Wells | Family Medicine | 611 S Chestnut St, Suite C, Ellensburg, WA 98926-4815 | 2007-04-02 |
| 1457494288 | Victoria Anne Perkis | Nurse Practitioner | 611 S Chestnut St, Suite E, Ellensburg, WA 98926-4815 | 2007-02-14 |
| 1720097280 | Frank L Smith | Surgery | 611 S Chestnut St, Suite A, Ellensburg, WA 98926-4815 | 2006-08-05 |
| 1356366363 | Elise J Herman | Pediatrics | 611 S Chestnut St, Suite E, Ellensburg, WA 98926-4815 | 2006-07-12 |
| 1639105992 | Ellensburg Pediatrics Pllc | Clinic/Center | 611 S Chestnut St, Suite E, Ellensburg, WA 98926-4815 | 2006-06-25 |
| 1952355281 | John H Sand | Specialist | 611 S Chestnut St, Ste B, Ellensburg, WA 98926-4815 | 2006-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407286214 | Sarah Rae | Occupational Therapist | 1050 E Mountian View Ave, Ellensburg, WA 98926 | 2013-11-14 |
| 1366885691 | Leslie-ann Fox I | Pharmacist | 521 East Mountain View Ave, Ellensburg, WA 98926 | 2013-04-17 |
| 1972877330 | Terri Lee Hughes | Pharmacist | 608 E Mountainview, Ellensburg, WA 98926 | 2012-03-02 |
| 1366716789 | Eiko Hama | Pharmacist | 608 E Mountain View, Ellensburg, WA 98926 | 2012-03-02 |
| 1689971228 | Carolyn Jeannette Brunk | Massage Therapist | 814 East 5th Avenue, Ellensburg, WA 98926 | 2011-02-17 |
| 1275862468 | Creekside Dental Ellensburg Pllc | Dentist | 2601 Triple L Loop, Ellensburg, WA 98926 | 2009-12-17 |
| 1659605038 | Michael Alan Patin | Pharmacist | 700 S. Main St., Ellensburg, WA 98926 | 2009-10-01 |
| 1538391040 | Brenden J Davis | Dentist | 1206 N Dolarway Rd Ste 208, Ellensburg, WA 98926 | 2009-08-17 |
| 1821206186 | Peggy Elaine Erickson | Massage Therapist | 314 E 4th, Ellensburg, WA 98926 | 2007-05-18 |
| 1295951259 | Kenneth Francis Kladnik | Specialist/Technologist | 1711 E. Canterbury, Ellesnburg, WA 98926 | 2007-04-18 |
| Find all providers in zip 98926 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932225315 | Ann Patricia Gorai | Orthopaedic Surgery | 611 S Chestnut St Ste E, Ellensburg, WA 98926-4815 | 2007-03-21 |
| 1407819766 | Gary D Bos | Orthopaedic Surgery | 611 S Chestnut St, Ste. D, Ellensburg, WA 98926-4815 | 2006-04-08 |
| 1023169372 | William Roby Pace IIi | Orthopaedic Surgery | 700 E Manitoba Ave, Suite 105, Ellensburg, WA 98926-3885 | 2007-01-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902418189 | Proliance Surgeons, Inc., P.s. | Orthopaedic Surgery | 2727 Hollycroft St Ste 410, Gig Harbor, WA 98335-1369 | 2020-08-19 |
| 1962968628 | Zachary Erin Schwartz | Orthopaedic Surgery | 9040 Fitzsimmons Drive- Orthopaedic Surgery, Joint Base Lewis Mcchord, WA 98431-1000 | 2019-02-18 |
| 1184106262 | Proliance Surgeons, Inc., P.s. | Orthopaedic Surgery | 18100 Ne Union Hill Rd Ste 330, Redmond, WA 98052-3330 | 2018-09-05 |
| 1356827828 | Seattle Spine Group, Pllc | Orthopaedic Surgery | 1220 116th Ave Ne Ste 102, Bellevue, WA 98004 | 2018-07-17 |
| 1184137770 | Walter Franklin Krengel Jr. | Orthopaedic Surgery | 2000 1st Ave Suite 2201, Seattle, WA 98122 | 2017-11-06 |
| 1821443383 | Chelan County Public Hospital District No 2 | Orthopaedic Surgery | 505 B State, Route 20, Winthrop, WA 98862 | 2016-05-03 |
| 1609254747 | William M Fallon | Orthopaedic Surgery | 3990 Saltspring Dr, Ferndale, WA 98248-9598 | 2015-05-08 |
| 1528470861 | Richard Dean Thorson | Orthopaedic Surgery | 719 S. Laurel St, Olympic Chiropractic, Port Angels, WA 98362 | 2014-05-21 |
| 1740600840 | Peters T. Otlans | Orthopaedic Surgery | 16259 Sylvester Rd Sw Ste 501, Burien, WA 98166-3059 | 2014-04-16 |
| 1912324559 | Floyd Sekeramayi | Orthopaedic Surgery | 630 N Fairview Dr, Tacoma, WA 98406-1015 | 2014-03-20 |
| Find all providers with the same taxonomy | ||||
| City | ELLENSBURG |
| Zip Code | 98926 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.