Individual provider Active NPI

Cory Heidelberger, MD

  • Emergency Medicine Physician
  • Bellevue, WA
National Provider Identifier
1063661296
Registry record updated Mar 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD60322364 Issued in WA
Practice address
1035 116TH Ave NE
Bellevue, WA 98004-4604
Phone
(425) 688-5759
NPI assigned
Sep 11, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD60322364 WA Primary
Emergency Medicine Physician 207P00000X 13622 NV

Addresses

Primary practice location

1035 116TH Ave NE
Bellevue, WA 98004-4604

Mailing address

1035 116TH Ave NE
Bellevue, WA 98004-4604

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
I20130121000222 WA Practitioner - Emergency Medicine 5597957860 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Utah School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Puget Sound Physicians PLLCGroup PAC ID 2961301882, 47 clinicians

Practice addresses (Care Compare)

1035 116TH Ave NE
Bellevue, WA 98004-4604
Phone (425) 688-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.26 of 100Reported as group
Quality
95.59
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
83.74 of 100Reported as group
Quality
78.83
Promoting interoperability
100
Improvement activities
40
Cost
66.97

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60322364WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ballard Emergency Physicians, P.S. Emergency Medicine CurrentSince Nov 5, 2013 Accepting new patients
Northwest Emergency Physicians LLC Emergency Medicine CurrentSince Jan 1, 2013 Accepting new patients
Puget Sound Physicians PLLC Emergency Medicine CurrentSince Feb 1, 2015 Accepting new patients
Public Hospital District No 4, King County Wa Family Medicine Past Accepting new patients

Locations

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

34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100

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

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

5300 Tallman Ave NW
Seattle, WA 98107
Phone (206) 781-6209

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1221091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458172800000",
    "number": "1063661296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 116TH AVE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 116TH AVE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044604",
            "telephone_number": "425-688-5759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIDELBERGER",
        "first_name": "CORY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-11",
        "last_updated": "2016-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD60322364",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NV",
            "license": "13622",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.