Kendall C Shibuya, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OP61071725 Issued in WA

Practice address

26401 Pacific Hwy S Ste 101
Des Moines, WA 98198-9247

Phone

(206) 870-3590

Fax

(206) 824-1670

NPI assigned

Jun 18, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Swedish Health ServicesGroup PAC ID 0244138196, 1,038 clinicians

Seattle Roots Community HealthGroup PAC ID 8628966173, 50 clinicians

HealthpointGroup PAC ID 9335042886, 175 clinicians

Swedish Health ServicesGroup PAC ID 4183522931, 23 clinicians

International Community Health ServicesGroup PAC ID 5799695672, 95 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kshibuya1043237@wm.providencedirect.org

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.

• Healthpoint

  • Federally Qualified Health Center (FQHC)
  • Kent, WA
  • NPI 1831199454

  Family Medicine

  Medicare reassignment Care Compare group NPD
• International Community Health Services

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
  • NPI 1376659151

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Swedish Health Services

  • Internal Medicine Physician
  • Seattle, WA
  • NPI 1689612954
  Medicare reassignment Care Compare group NPD
• Swedish Health Services

  • Family Medicine Physician
  • Seattle, WA
  • NPI 1720033145
  Medicare reassignment Care Compare group NPD
• Seattle Roots Community Health

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
  • NPI 1972623189
  Medicare reassignment Care Compare group
• Healthpoint

  • Federally Qualified Health Center (FQHC)
  • Renton, WA
  • NPI 1093237737
  NPD
• Healthpoint

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
  • NPI 1770471377
  NPD
• International Community Health Services

  • Federally Qualified Health Center (FQHC)
  • Auburn, WA
  • NPI 1831910439
  NPD
• International Community Health Services

  • Federally Qualified Health Center (FQHC)
  • Shoreline, WA
  • NPI 1992124747

  Family Medicine

  NPD
• Seattle Roots Community Health

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
  • NPI 1356999288

  Family Medicine

  NPD
• Seattle Roots Community Health

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
  • NPI 1891343075

  Family Medicine

  NPD
• Healthpoint

  • Federally Qualified Health Center (FQHC)
  • Redmond, WA
  • NPI 1891795621

  Family Medicine

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1434585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762732800000",
    "number": "1013399781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 POWELL AVE SW",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572908",
            "telephone_number": "425-277-1311",
            "fax_number": "425-277-1566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26401 PACIFIC HWY S STE 101",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981989247",
            "telephone_number": "206-870-3590",
            "fax_number": "206-824-1670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 NW Market St Ste 403",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981073901",
            "country_code": "US",
            "telephone_number": "206-297-5100",
            "fax_number": "206-297-5151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIBUYA",
        "first_name": "KENDALL",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-18",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP61071725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013399781",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kshibuya28941@healthpoint.direct-ci.com",
            "affiliation": "N",
            "address_1": "26401 Pacific Hwy S Ste 101",
            "city": "Des Moines",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981989247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sea-Mar Community Health Center
• Nikeeta Shah, DO
• Shiva Shalbaf, PHARM.D
• Salahaddin Shamdeen, SOLE PROPRIETOR
• Jameelah Dorhosti Sheridan, LMP HHP
• Tetsuya Shirasuka, DDS
• Wendelyn Shue
• Gurjeet K Sidhu, LMFT
• Julie Siegfried
• Silver Cliff PLLC

• Family Medicine Physician in Des Moines, WA
• Providers in Des Moines, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.