Organization Active NPI

West Seattle Foot & Ankle Clinic, LLC

  • Foot & Ankle Surgery Podiatrist
  • Seattle, WA
National Provider Identifier
1124206115
Registry record updated Dec 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO00000396 Issued in WA
Legal business name
WEST SEATTLE FOOT & ANKLE CLINIC, LLC
Practice address
4520 42ND Ave SW
Suite 34
Seattle, WA 98116-4240
Phone
(206) 937-4700
Fax
(206) 937-4778
NPI assigned
Feb 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2022

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

Authorized official

Name
Casie Labella
Title
Practice Administrator
Phone
(206) 937-4700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X PO00000396 WA Primary

Addresses

Primary practice location

4520 42ND Ave SW
Suite 34
Seattle, WA 98116-4240

Mailing address

4520 42ND Ave SW
Suite 34
Seattle, WA 98116-4240
Phone (206) 937-4700

Other names 1

  • West Seattle Foot & Ankle Clinic, PLLC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20151110000434 WA Part B Supplier - Clinic/Group Practice 8527140300 Receives reassigned benefits from 3 practitioners
Practice locations: Seattle, WA
O20230217002159 WA Part B Supplier - Clinic/Group Practice 1557733607 Receives reassigned benefits from 2 practitioners
Practice locations: Seattle, WA

National Provider Directory

National Provider Directory

Locations

4520 42nd Ave SW
Seattle, WA 98116

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1201824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671408000000",
    "number": "1124206115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4520 42ND AVE SW",
            "address_2": "SUITE 34",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981164240",
            "telephone_number": "206-937-4700",
            "fax_number": "206-937-4778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4520 42ND AVE SW",
            "address_2": "SUITE 34",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981164240",
            "telephone_number": "206-937-4700",
            "fax_number": "206-937-4778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST SEATTLE FOOT & ANKLE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-01",
        "last_updated": "2022-12-19",
        "certification_date": "2022-12-19",
        "status": "A",
        "authorized_official_last_name": "LABELLA",
        "authorized_official_first_name": "CASIE",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "206-937-4700"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WA",
            "license": "PO00000396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Seattle Foot & Ankle Clinic, PLLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.