Active NPI
Katie Micheletti, AUD
- Audiologist
- Tacoma, WA
National Provider Identifier
1053097154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- LD61445493
- Practice address
- 5821 S Sprague CT
Tacoma, WA 98409-6903 - Phone
- (253) 396-4250
- NPI assigned
- Jun 23, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | LD61445493 | WA | Primary |
Addresses
Primary practice location
5821 S Sprague CT
Tacoma, WA 98409-6903
Mailing address
2715 25TH Ave S Unit 437
Seattle, WA 98144-5322
Phone (925) 209-1709
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230801002080 | WA | Practitioner - Qualified Audiologist | 5092176537 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Audiologist
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Kaiser Foundation Health Plan of Washington
Practice addresses (Care Compare)
5821 S Sprague CT
Tacoma, WA 98409-6903
Phone (253) 396-4200
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LD61445493 | WA | MD | Audiologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients |
Locations
200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530
9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800
5821 S Sprague Ct
Tacoma, WA 98409
Phone (253) 396-4200
Interoperability endpoints
- kmicheletti4266771@ghc.direct-ci.net
Organizations & group practices 8
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.
-
- Multi-Specialty Clinic/Center
- Seattle, WA
- NPI 1396810701
WA
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- Clinical Medical Laboratory
- Renton, WA
- NPI 1285805119
-
- Community Based Hospice Care Agency
- Seattle, WA
- NPI 1437289576
-
- Home Health Agency
- Seattle, WA
- NPI 1528198660
-
- General Acute Care Hospital
- Seattle, WA
- NPI 1861522088
-
- Ambulatory Surgical Clinic/Center
- Bellevue, WA
- NPI 1972774180
-
- Multi-Specialty Clinic/Center
- Renton, WA
- NPI 1124264577
-
- Multi-Specialty Clinic/Center
- Everett, WA
- NPI 1386935351
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693180800000",
"number": "1053097154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2715 25TH AVE S UNIT 437",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981445322",
"telephone_number": "925-209-1709"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5821 S SPRAGUE CT",
"city": "TACOMA",
"state": "WA",
"postal_code": "984096903",
"telephone_number": "253-396-4250"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICHELETTI",
"first_name": "KATIE",
"credential": "AUD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-23",
"last_updated": "2023-08-28",
"certification_date": "2023-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "WA",
"license": "LD61445493",
"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": "5821 S Sprague Ct",
"city": "Tacoma",
"state": "WA",
"country_code": "US",
"postal_code": "984096903",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.