Samuel Moulton, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

MD61435678 Issued in WA

Practice address

510 8TH Ave NE Ste 200
Issaquah, WA 98029-5436

Phone

(425) 392-3030

Fax

(425) 392-2564

NPI assigned

Apr 12, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 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

Orthopedic SurgeryAlso: Sports Medicine

Education

Oregon Health Sciences University School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Proliance Surgeons Inc P SGroup PAC ID 8527972900, 395 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Evergreenhealth Home Care Services Home health agency, Kirkland, WA, CCN 507079
• Swedish Issaquah Hospital, Issaquah, WA, CCN 500152
• Overlake Hospital Medical Center & Clinics Hospital, Bellevue, WA, CCN 500051

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Proliance Surgeons Inc P S

  • Orthopaedic Surgery Physician
  • Seattle, WA
  • NPI 1023170313
  Medicare reassignment Care Compare group NPD
• Proliance Surgeons Inc P S

  • Orthopaedic Surgery Physician
  • Renton, WA
  • NPI 1235091463
  NPD
• Proliance Surgeons, Inc., P.S.

  • Surgery Physician
  • Bellevue, WA
  • NPI 1578801718
  NPD
• Proliance Surgeons, Inc., P.S.

  • Otolaryngology Physician
  • Burien, WA
  • NPI 1114108784
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• King County Public Hospital District No. 2

  • Home Health Agency
  • Kirkland, WA
  • NPI 1588662761
  Care Compare affiliation
• Overlake Medical Center & Clinics

  • General Acute Care Hospital
  • Bellevue, WA
  • NPI 1598971855
  Care Compare affiliation
• Overlake Medical Center & Clinics

  • General Acute Care Hospital
  • Bellevue, WA
  • NPI 1861432726
  Care Compare affiliation
• Swedish Health Services

  • General Acute Care Hospital
  • Issaquah, WA
  • NPI 1851686059
  Care Compare affiliation

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

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1043744527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 8TH AVE NE STE 320",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980295436",
            "telephone_number": "425-392-3030",
            "fax_number": "425-392-2564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 8TH AVE NE STE 200",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980295436",
            "telephone_number": "425-392-3030",
            "fax_number": "425-392-2564"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "18100 NE Union Hill Rd Ste 330",
            "address_purpose": "LOCATION",
            "city": "Redmond",
            "state": "WA",
            "postal_code": "980523330",
            "country_code": "US",
            "telephone_number": "425-455-3600",
            "fax_number": "425-455-3920",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "515 Minor Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981042133",
            "country_code": "US",
            "telephone_number": "425-455-3600",
            "fax_number": "425-455-3920",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3101 Northup Way Ste 201",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980041449",
            "country_code": "US",
            "telephone_number": "425-455-3600",
            "fax_number": "425-455-3920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOULTON",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-12",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "WA",
            "license": "MD61435678",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WA",
            "license": "MD61435678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2082179",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Gale Morton, M.A., LMHC
• Kara Lynn Moscovitz, PHD
• Allison Taylor Moses
• Jacobo Francisco Mosquera, DPT
• Nima Motazedian, DDS
• Emily Kathryn Mowrer
• Ashleigh Mueller, PA-C
• Paul Muburi Muita
• Geetika Mukkamala, OTD
• Patricia Ann Mullen, ND

• Orthopaedic Surgery Physician in Issaquah, WA
• Providers in Issaquah, WA by specialty
• Orthopaedic Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; 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.