Kirk Damien Danielson, MD

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

MD00047934 Issued in WA

Practice address

1959 NE Pacific St
C-212, Box 356340
Seattle, WA 98195-6340

Phone

(206) 543-0065

NPI assigned

Aug 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 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

Physical Medicine and Rehabilitation

Education

Oregon Health Sciences University School of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Health and Services WashingtonGroup PAC ID 6709782600, 480 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Providence Centralia Hospital Hospital, Centralia, WA, CCN 500019
• Providence St Peter Hospital Hospital, Olympia, WA, CCN 500024

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Providence Health & Services Washington

  dba Providence Medical Group SouthWest Washington

  • Family Medicine Physician
  • Olympia, WA
  • NPI 1174744304
  Medicare reassignment Care Compare group
• Providence Health & Services Washington

  dba Providence Centralia Hospital

  • General Acute Care Hospital
  • Centralia, WA
  • NPI 1376624981
  Medicare reassignment NPD
• Providence Health & Services Washington

  • General Acute Care Hospital
  • Olympia, WA
  • NPI 1619176997
  Medicare reassignment NPD
• Providence Health & Services Washington

  dba Providence Community Care Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Olympia, WA
  • NPI 1023550050
  NPD
• Providence Health & Services Washington

  • General Acute Care Hospital
  • Centralia, WA
  • NPI 1275732661
  NPD
• Providence Health & Services Washington

  dba Providence Centralia Hospital

  • Radiation Oncology Clinic/Center
  • Aberdeen, WA
  • NPI 1457721250
  NPD

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

• Providence Health & Services Washington

  dba Providence St Peter Hospital

  • General Acute Care Hospital
  • Olympia, WA
  • NPI 1346250594
  Care Compare affiliation
• Providence Health & Services Washington

  dba Providence Centralia Hospital

  • General Acute Care Hospital
  • Centralia, WA
  • NPI 1376624981
  Care Compare affiliation
• Providence Health & Services Washington

  • General Acute Care Hospital
  • Olympia, WA
  • NPI 1619176997
  Care Compare affiliation

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1093820797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "address_2": "C-212, BOX 356340",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981956340",
            "telephone_number": "206-543-0065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "address_2": "C-212, BOX 356340",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981956340",
            "telephone_number": "206-543-0065"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Cooks Hill Rd Ste E",
            "address_purpose": "LOCATION",
            "city": "Centralia",
            "state": "WA",
            "postal_code": "985319162",
            "country_code": "US",
            "telephone_number": "360-330-8626",
            "fax_number": "360-807-7983",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DANIELSON",
        "first_name": "KIRK",
        "middle_name": "DAMIEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WA",
            "license": "MD00047934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARBORVIEW MEDICARE",
            "identifier": "8865589",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8480550",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UWP MEDICARE",
            "identifier": "8866009",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kdanielson92239@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1800 Cooks Hill Rd Ste E",
            "city": "Centralia",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985319162",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ruth Daniels, BCBA, LBA
• Starla Raye Daniels
• Stephen David Daniels, MD
• Amy Jean Danielson, PT
• Benjamin S Danielson
• Per E. Danielsson, MD
• Benjamin G Danis, PH.D.
• Carole Marie Danis, MSW, LICSW
• Dorender Appiah Dankwa
• Audrey Owusua Dankwah

• Physical Medicine & Rehabilitation Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Physical Medicine & Rehabilitation Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; 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.