Individual provider Active NPI

Garrett Matthew Koslan, CNM

  • Advanced Practice Midwife
  • Bellevue, WA
National Provider Identifier
1053058289
Registry record updated Sep 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
AP61314370 Issued in WA
Practice address
11511 NE 10TH St
Bellevue, WA 98004-8578
Phone
(425) 502-3000
Fax
(425) 502-4233
NPI assigned
May 18, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
MidwifeGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 176B00000X
Advanced Practice Midwife 367A00000X AP61314370 WA Primary

Addresses

Primary practice location

11511 NE 10TH St
Bellevue, WA 98004-8578

Mailing address

11511 NE 10TH St
Bellevue, WA 98004-8578
Phone (425) 502-3000

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221010002743 WA Practitioner - Certified Nurse Midwife (CNM) 2466838701 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington Single Specialty Current Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Sep 6, 2022 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Sep 6, 2022 Accepting new patients

Locations

11511 NE 10th St
Hunts Point, WA 98004
Phone (425) 502-3000

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: gkoslan4133704@ghc.direct-ci.net

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": "1652832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663977600000",
    "number": "1053058289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 NE 10TH ST",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980048578",
            "telephone_number": "425-502-3000",
            "fax_number": "425-502-3589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11511 NE 10TH ST",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980048578",
            "telephone_number": "425-502-3000",
            "fax_number": "425-502-4233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSLAN",
        "first_name": "GARRETT",
        "middle_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "CNM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-05-18",
        "last_updated": "2022-09-24",
        "certification_date": "2022-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Midwife",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "WA",
            "license": "AP61314370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "11511 NE 10th St",
            "city": "Bellevue",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980048578",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.