Active NPI 1891779195 Individual Practitioner Male Practitioner

Dr. Jack Mark Fishaut , MD

Pediatrics • Friday Harbor, WA

Professional Overview & Biography Verified Profile Summary

Dr. Jack Fishaut, MD is a registered healthcare professional specializing in Pediatrics in Friday Harbor, WA. Practice services are available at 235 BLAIR AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

235 Blair Ave

Friday Harbor, WA 982500796

Telephone 3603705971

Fax 3603705980

Associated Practice Facility / Clinic

🏢 Friday Harbor Family Clinic Pllc Facility NPI 1861143398

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Friday Harbor, WA

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.5 Yrs

State Avg: 18.8 Yrs

Regional Practice Density

1 Specialists

Practicing in Friday Harbor, WA (1802 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2022-02-11

Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License WA MD00040965

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Park Natl L & L

361929500

Commercial Insurance / Payer ID Group Health

532300004

Commercial Insurance / Payer ID Regence Blue Shield

4952FI

Commercial Insurance / Payer ID Uniform

912109329

Commercial Insurance / Payer ID Chpw

912109329

Commercial Insurance / Payer ID Premera Blue Cross

912109329

Commercial Insurance / Payer ID 0182789

LABOR AND INDUSTRIES

Commercial Insurance / Payer ID Dshs Medicaid

8387367

Commercial Insurance / Payer ID First Choice

912109329

Commercial Insurance / Payer ID Crime Victims

8930937

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events

📍

Updated Practice Location February 22, 2022

Registered at 235 BLAIR AVE, FRIDAY HARBOR, WA 982500796 (Tel: 3603705971)

📍

Updated Business Mailing Address February 11, 2022

Registered at PO BOX 796, FRIDAY HARBOR, WA 982500796 (Tel: 3603705971)

✅

NPI Profile Active September 14, 2012

NPI status registered as active in NPPES database

📍

Updated Practice Location September 14, 2012

Registered at 689 AIRPORT CENTER DRIVE, SUITE B, FRIDAY HARBOR, WA 982507187 (Tel: 3603781338)

📍

Updated Business Mailing Address September 14, 2012

Registered at PO BOX 1550, FRIDAY HARBOR, WA 982501550 (Tel: 3603781338)

👤

Provider Name / Credentials Updated September 14, 2012

Recorded as JACK FISHAUT, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) September 14, 2012

Pediatrics (License #MD00040965 in WA)

🟢

Initial NPI Registration & Enumeration December 01, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1891779195

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: December 01, 2005

Last Update: March 07, 2023

Sole Proprietor: No

Update or Correct Profile

Mailing Address

Po Box 796

Friday Harbor, WA 982500796

Phone: 3603705971

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.