Individual provider Active NPI

Stephen W Marshall, MD

  • Emergency Medicine Physician
  • Bellevue, WA
National Provider Identifier
1043313067
Registry record updated Jul 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
23730 Issued in WA
Practice address
1035 116TH Avenue NE
Bellevue, WA 98004
Phone
(425) 688-5759
Fax
(425) 688-5101
NPI assigned
Sep 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 23730 WA Primary

Addresses

Primary practice location

1035 116TH Avenue NE
Bellevue, WA 98004

Mailing address

PO Box 34960
Seattle, WA 98124-1960
Phone (425) 656-4255

Other identifiers 1

IdentifierTypeStateIssuer
8602161MedicaidWA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050322001060 WA Practitioner - Emergency Medicine 3072580422 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
23730WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Puget Sound Physicians PLLC Emergency Medicine CurrentSince Oct 1, 1995 Accepting new patients
Issaquah Obstetrics and Gynecology PLLC Past Accepting new patients
Overlake Medical Clinics LLC Past Accepting new patients
Overlake Medical Clinics, LLC Past Accepting new patients
Public Hospital District No 4, King County Wa Past Accepting new patients

Locations

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

3011 196th St SW
Lynnwood, WA 98036
Phone (425) 688-5759

Organizations & group practices 5

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": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278547200000",
    "number": "1043313067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34960",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241960",
            "telephone_number": "425-656-4255",
            "fax_number": "425-656-4003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 116TH AVENUE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98004",
            "telephone_number": "425-688-5759",
            "fax_number": "425-688-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "STEPHEN",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2010-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "23730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8602161",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.