Individual provider Active NPI

Katherine Jeanne Oberhofer, MS CCC-SLP

  • Speech-Language Pathologist
  • Bellevue, WA
National Provider Identifier
1023082286
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
LL60201290 Issued in WA
Practice address
1417 116TH Ave NE Ste 110
Bellevue, WA 98004-3821
Phone
(425) 688-5911
Fax
(425) 688-5912
NPI assigned
Feb 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2202004899 VA
Speech-Language Pathologist 235Z00000X LL60201290 WA Primary

Addresses

Primary practice location

1417 116TH Ave NE Ste 110
Bellevue, WA 98004-3821

Mailing address

2924 Queen Anne Ave N
Seattle, WA 98109-1728
Phone (509) 374-3920

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130930000235 WA Practitioner - Qualified Speech Language Pathologist 2860626124 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Overlake Medical Clinics LLCGroup PAC ID 7012808827, 423 clinicians

Practice addresses (Care Compare)

1417 116TH Ave NE
Suite 110
Bellevue, WA 98004-3821
Phone (425) 688-5900

Merit-based Incentive Payment System (MIPS)

Final score
86.73 of 100Reported as apm
Quality
73.46
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2202004899VAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Sun River Speech Therapy, LLC CurrentSince Oct 31, 2013 Accepting new patients
Overlake Medical Clinics LLC CurrentSince Jul 26, 2021 Accepting new patients
Overlake Medical Clinics, LLC CurrentSince Jul 26, 2021 Accepting new patients

Locations

1417 116th Ave NE
Ste 110
Bellevue, WA 98004
Phone (425) 688-5700

1750 112th Ave NE
Ste B102
Bellevue, WA 98004
Phone (425) 688-5460

303 Bradley Blvd
Ste 102
Richland, WA 99352
Phone (509) 521-4034

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1023082286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2924 QUEEN ANNE AVE N",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981091728",
            "telephone_number": "509-374-3920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 116TH AVE NE STE 110",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043821",
            "telephone_number": "425-688-5911",
            "fax_number": "425-688-5912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBERHOFER",
        "first_name": "KATHERINE",
        "middle_name": "JEANNE",
        "name_prefix": "Mrs.",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "VA",
            "license": "2202004899",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WA",
            "license": "LL60201290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; 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.