Katie Ellgass, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A130372 Issued in CA

Practice address

22180 Olympic College Way NW
Poulsbo, WA 98370-6664

Phone

(360) 626-4031

NPI assigned

Oct 29, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: katie.ellgass.1@13902.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• LPCH Medical Group Div of Lucile

  dba Lucile Salter Packard Children's Hospital at Stanford

  • Children's Hospital
  • Palo Alto, CA
  • NPI 1417907940

  Pediatrics

  Medicare reassignment NPD
• Peninsula Community Health Services

  • Dentist
  • Port Orchard, WA
  • NPI 1588041701
  NPD (past)
• Sound Pediatrics, PLLC

  • Pediatrics Physician
  • Poulsbo, WA
  • NPI 1306133533
  NPD (past)

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

{
    "created_epoch": "1225238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1093968570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10500 NE BYRON DR",
            "city": "BAINBRIDGE ISLAND",
            "state": "WA",
            "postal_code": "981101972",
            "telephone_number": "574-261-5040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22180 OLYMPIC COLLEGE WAY NW",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983706664",
            "telephone_number": "360-626-4031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2915 Telegraph Ave",
            "address_purpose": "LOCATION",
            "city": "Berkeley",
            "state": "CA",
            "postal_code": "947052060",
            "country_code": "US",
            "telephone_number": "510-843-4544",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLGASS",
        "first_name": "KATIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-29",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101247388",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A130372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Francie Corinn Edens, LMT
• Jennifer Edwards, DPT
• Katherine Egerer
• Ariel R Ehrlich, M.D.
• Elite Kitsap Performance Physical Therapy LLC (Elite Kitsap Performance Physical Therapy)
• Barbara Ellis-Danford
• Emeritus Corporation (Brookdale Montclair Poulsbo)
• Empowersyou Counseling Services
• Katie Lynn Ernst, APRN, DNP
• Hannah Elizabeth Kiel Erwert, ARNP

• Pediatrics Physician in Poulsbo, WA
• Providers in Poulsbo, WA by specialty
• Pediatrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.