NICHOLAS WAYNE SHEPHERD PA
NPI 1366164212
Physician Assistant - Surgical in Mount Vernon, WA

NPI Status: Active since September 16, 2022

Contact Information

2320 FREEWAY DR
MOUNT VERNON, WA
ZIP 98273
Phone: (360) 814-6800
Fax: (360) 814-6953

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  • Individual
  • Male
  • Years of Experience 4
  • Physician Assistant
  • Surgical
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About NICHOLAS SHEPHERD

This page provides the complete NPI Profile along with additional information for Nicholas Shepherd, a provider established in Mount Vernon, Washington with a medical specialization in Physician Assistant, focusing in surgical and more than 4 years of experience. The healthcare provider is registered in the NPI registry with number 1366164212 assigned on September 2022. The practitioner's primary taxonomy code is 363AS0400X with license number PA61352920 (WA). The provider is registered as an individual and his NPI record was last updated 3 years ago.

NPI
1366164212
Provider Name
NICHOLAS WAYNE SHEPHERD PA
Gender
Male
Entity Type
Individual
Location Address
2320 FREEWAY DR MOUNT VERNON, WA 98273
Location Phone
(360) 814-6800
Location Fax
(360) 814-6953
Mailing Address
1400 E KINCAID ST MOUNT VERNON, WA 98274
Medical School Name
OTHER
Graduation Year
2022
Is Sole Proprietor?
No
Enumeration Date
09-16-2022
Last Update Date
11-18-2022
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Location Map

Secondary Locations

  • 1400 E Kincaid St
    Mount Vernon, WA 98274
    (360) 428-2550

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

Physician Assistant Surgical

Taxonomy Code
363AS0400X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
PA61352920
License State
WA

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1363A00000XPhysician Assistants & Advanced Practice Nursing Providers

Physician Assistant

PA61352920 (WA)

Insurance Plans Accepted

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

  • 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

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

Medicare Participation & PECOS Enrollment Status

Nicholas Shepherd 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.

Nicholas Shepherd 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: 941679591

    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: I20221204000028

    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

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Nicholas Shepherd is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
SKAGIT VALLEY HOSPITAL1415 E KINCAID STREET
MOUNT VERNON, WA 98274
(360) 424-4111Acute Care Hospitals
WHIDBEYHEALTH MEDICAL CENTER101 NORTH MAIN STREET
COUPEVILLE, WA 98239
(360) 678-5151Critical Access Hospitals

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1366164212
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2312626822
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 3 + 1 + 2 + 6 + 2 + 6 + 8 + 2 + 2 + 24 = 58
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 58 = 22

The NPI number 1366164212 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1326242801 ROBERT M. LIPSCOMB M.D.
Individual
Orthopaedic Surgery2320 FREEWAY DR
MOUNT VERNON, WA 98273
(360) 814-6800
1518914811 KATHLEEN MARY O'NEILL PAC
Individual
Physician Assistant2320 FREEWAY DR
MOUNT VERNON, WA 98273
(360) 814-6800
1558564617 DEENA VICHUGSANANON M.D.
Individual
Pediatrics2320 FREEWAY DR PEDIATRICS
MOUNT VERNON, WA 98273
(360) 814-6870
1043577562MR. LUKE M WALTERS PA-C
Individual
Physician Assistant (Medical)2320 FREEWAY DR
MOUNT VERNON, WA 98273
(360) 814-6810
1326139700DR. MARIEL CASTILLO MD
Individual
Pediatrics2320 FREEWAY DR
MOUNT VERNON, WA 98273
(360) 814-6870
1356451249MR. RICHARD EMANUEL MANOS M.D.
Individual
Orthopaedic Surgery (Orthopaedic Surgery of the Spine)2320 FREEWAY DR
MOUNT VERNON, WA 98273
(360) 814-6800
1407218969 MARI HAMMERQUIST OATHES D.O.
Individual
Pediatrics2320 FREEWAY DR
MOUNT VERNON, WA 98273
(360) 814-6870
1568775922 NAVID MEHRABAN MD
Individual
Internal Medicine (Rheumatology)2320 FREEWAY DR
MOUNT VERNON, WA 98273
(360) 428-2550
1073878088 ALEXANDER WILLIS M.D.
Individual
Orthopaedic Surgery2320 FREEWAY DR
MOUNT VERNON, WA 98273
(360) 814-6800
1700326824 SHANNAN THERESA O'BRIEN PA-C
Individual
Physician Assistant (Surgical)2320 FREEWAY DR
MOUNT VERNON, WA 98273
(360) 814-6880
1215208970 RUTHIE MAY UY CHUA M.D.
Individual
Internal Medicine (Rheumatology)2320 FREEWAY DR
MOUNT VERNON, WA 98273
(360) 428-2550
1598119737 MICHAEL T BARTON MD
Individual
Dermatology2320 FREEWAY DR
MOUNT VERNON, WA 98273
(360) 814-6810
1609171347 LAURA S. GRANTHAM PAC
Individual
Physician Assistant (Medical)2320 FREEWAY DR
MOUNT VERNON, WA 98273
(360) 428-2550
1033688981 ASHTON TAYLOR DE CARDENAS PA-C
Individual
Physician Assistant (Surgical)2320 FREEWAY DR
MOUNT VERNON, WA 98273
(360) 814-6800
1487063442 BRITTANY SHEPHERD GRYTDAHL PA-C
Individual
Physician Assistant (Surgical)2320 FREEWAY DR
MOUNT VERNON, WA 98273
(360) 814-2663
1326309113 MEGAN M. IRWIN PA-C
Individual
Physician Assistant (Medical)2320 FREEWAY DR
MOUNT VERNON, WA 98273
(360) 428-2550
1033525712 PAULA ANDRADE WOLFF ARNP
Individual
Nurse Practitioner (Family)2320 FREEWAY DR
MOUNT VERNON, WA 98273
(360) 814-6850
1396071601 JENNIFER ANN ELLIOTT ARNP
Individual
Nurse Practitioner (Family)2320 FREEWAY DR
MOUNT VERNON, WA 98273
(360) 814-6850
1992743215 BILL STAHLBERG PA-C
Individual
Physician Assistant (Surgical)2320 FREEWAY DR
MOUNT VERNON, WA 98273
(360) 814-6800
1528484417DR. RICHARD DYLAN MORRIS D.O.
Individual
Orthopaedic Surgery (Orthopaedic Surgery of the Spine)2320 FREEWAY DR
MOUNT VERNON, WA 98273
(360) 814-6800

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1366164212, enumerated in the NPI registry as an "individual" on September 16, 2022

The provider is located at 2320 Freeway Dr Mount Vernon, Wa 98273 and the phone number is (360) 814-6800

The provider's speciality is Physician Assistant with taxonomy code 363AS0400X with a focus in Surgical

The provider has more than 4 years of experience.

The provider might be accepting Accepts: Premera Blue Cross Blue Shield of Alaska. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary 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.

The practitioner is affiliated to the following hospital(s): SKAGIT VALLEY HOSPITAL and WHIDBEYHEALTH MEDICAL CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on September 16, 2022. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.