NPIMap

Organization Active NPI

Puget Sound Kidney Centers

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Lakewood, WA
National Provider Identifier
1013572064
Registry record updated May 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X
Legal business name
PUGET SOUND KIDNEY CENTERS
Practice address
11950 47TH Ave SW
Lakewood, WA 98499
Phone
(425) 259-5195
Fax
(425) 258-9610
NPI assigned
May 6, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2019

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

Authorized official

Name
Ken Kouchi
Title
Chief Financial Officer
Phone
(425) 259-5195

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Primary

Addresses

Primary practice location

11950 47TH Ave SW
Lakewood, WA 98499

Mailing address

1019 Pacific Ave
Everett, WA 98201-4148
Phone (425) 259-5195

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kenk@pskc.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20171005001174 WA Part B Supplier - Clinic/Group Practice 3476501560 Receives reassigned benefits from 1 practitioner
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Arlington, WA; Everett, WA; Lakewood, WA; Monroe, WA; Mountlake Terrace, WA; Oak Harbor, WA; Anacortes, WA
O20190815002108 WA Part A Provider - End-Stage Renal Disease Facility (ESRD) 3476501560 Practice locations: Lakewood, WA

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Dialysis facility

Medicare Care Compare
Listed as
Puget Sound Kidney Centers-LakewoodCCN 502600
Overall star rating
2.0 of 5
Ownership
Non-profit
Certified
Jan 24, 2020
Medicare certification status
ActiveFrom the Provider of Services file
Chain
Puget Sound Kidney Centers
Dialysis stations
30

Name & address match This facility record has no NPI; it was connected to this NPI by matching name and address.

National Provider Directory

National Provider Directory
Tax ID family
Puget Sound Kidney Centers11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

11950 47th Ave SW
Lakewood, WA 98499
Phone (253) 393-6444

NPI Registry JSON

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

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557100800000",
    "number": "1013572064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 PACIFIC AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014148",
            "telephone_number": "425-259-5195",
            "fax_number": "425-258-9610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11950 47TH AVE SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "98499",
            "telephone_number": "425-259-5195",
            "fax_number": "425-258-9610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUGET SOUND KIDNEY CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-06",
        "last_updated": "2019-05-06",
        "status": "A",
        "authorized_official_last_name": "KOUCHI",
        "authorized_official_first_name": "KEN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "425-259-5195"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kenk@pskc.net",
            "affiliation": "N",
            "endpointDescription": "Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "11950 47th Ave SW",
            "city": "Lakewood",
            "state": "WA",
            "country_code": "US",
            "postal_code": "98499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.