NPIMap

Organization Active NPI

Eastside Pulmonary Associates Inc PS

  • Pulmonary Disease Physician
  • Bellevue, WA
National Provider Identifier
1083817936
Registry record updated Jan 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
MD00013991 Issued in WA
Legal business name
EASTSIDE PULMONARY ASSOCIATES INC PS
Practice address
919 109TH Ave NE
Bellevue, WA 98004-4485
Phone
(425) 646-3993
Fax
(425) 453-8274
NPI assigned
Jun 7, 2007
Last updated
Jan 3, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2012

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

Authorized official

Name
Dr. Barry Lyon Marmorstein, M.D.
Title
Physician
Phone
(425) 761-6401

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X MD00013991 WA Primary

Addresses

Primary practice location

919 109TH Ave NE
Bellevue, WA 98004-4485

Mailing address

PO Box 88
Ronald, WA 98940-0088
Phone (425) 761-6401

Other identifiers 6

IdentifierTypeStateIssuer
0014435OtherWALABOR & INDUSTRIES
336277300OtherWAFEDERAL DEPT OF LABOR
M123OtherWAREGENCE BLUE SHIELD
8921640OtherWAL&I CRIME VICTIMS UNIT
5558MAOtherWAREGENCE BLUE SHIELD
7123961MedicaidWA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325548800000",
    "number": "1083817936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 88",
            "city": "RONALD",
            "state": "WA",
            "postal_code": "989400088",
            "telephone_number": "425-761-6401",
            "fax_number": "509-674-6896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 109TH AVE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044485",
            "telephone_number": "425-646-3993",
            "fax_number": "425-453-8274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE PULMONARY ASSOCIATES INC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2012-01-03",
        "status": "A",
        "authorized_official_last_name": "MARMORSTEIN",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "LYON",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "425-761-6401",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WA",
            "license": "MD00013991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0014435",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL DEPT OF LABOR",
            "identifier": "336277300",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "M123",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I CRIME VICTIMS UNIT",
            "identifier": "8921640",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "5558MA",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7123961",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.