Individual provider Active NPI

Balraj Kaur

  • Adult Health Nurse Practitioner
  • Bellevue, WA
National Provider Identifier
1003440322
Registry record updated Jan 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
AP61098388 Issued in WA
Practice address
11120 NE 33Rd PL Ste 202
Bellevue, WA 98004-1444
Phone
(206) 823-1004
NPI assigned
Feb 25, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fandm Healthcare, LLC 30 clinicians
Daiya Healthcare PLLC 80 clinicians

Practice addresses (Care Compare)

Tacoma, WA 98406
Phone (253) 777-1423

11120 NE 33Rd PL
Suite 202
Bellevue, WA 98004-1444
Phone (206) 823-1004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201210000791 WA Practitioner - Nurse Practitioner 0941612253 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN60462529WAMDRegistered Nurse
AP61098388WAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Daiya Healthcare PLLC CurrentSince Oct 2, 2020 Accepting new patients
F&M Healthcare, LLC CurrentSince Oct 1, 2025 Accepting new patients

Locations

11120 NE 33rd Pl
Ste 202
Bellevue, WA 98004
Phone (206) 426-2584

6824 19th St W
#256
University Place, WA 98466
Phone (253) 777-1423

NPPES NPI Registry

Updated by the provider on Jan 29, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN60462529 WA
Adult Health Nurse Practitioner 363LA2200X AP61098388 WA Primary

Addresses

Primary practice location

11120 NE 33Rd PL Ste 202
Bellevue, WA 98004-1444

Mailing address

11120 NE 33Rd PL Ste 202
Bellevue, WA 98004-1444
Phone (206) 823-1004

Other practice location 1

1959 NE Pacific St
Seattle, WA 98195-0001
Phone (206) 543-8736

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 29, 2021.

{
    "created_epoch": "1582588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611878400000",
    "number": "1003440322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11120 NE 33RD PL STE 202",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980041444",
            "telephone_number": "206-823-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11120 NE 33RD PL STE 202",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980041444",
            "telephone_number": "206-823-1004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1959 NE Pacific St",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981950001",
            "country_code": "US",
            "telephone_number": "206-543-8736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAUR",
        "first_name": "BALRAJ",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-25",
        "last_updated": "2021-01-29",
        "certification_date": "2021-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60462529",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WA",
            "license": "AP61098388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.