Individual provider Active NPI

Kristen Brewer Sherman

  • Clinical Psychologist
  • Kirkland, WA
National Provider Identifier
1144305962
Registry record updated Nov 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY00002299 Issued in WA
Practice address
12039 NE 128TH St
Ste 200
Kirkland, WA 98034-3030
Phone
(425) 899-3140
Fax
(425) 899-3670
NPI assigned
Oct 27, 2006
Last updated
Nov 8, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PY00002299 WA
Clinical Psychologist 103TC0700X PY00002299 WA Primary

Addresses

Primary practice location

12039 NE 128TH St
Ste 200
Kirkland, WA 98034-3030

Mailing address

PO Box 34036
Seattle, WA 98124-1036
Phone (425) 899-3292

Other identifiers 2

IdentifierTypeStateIssuer
8352932MedicaidWA
251940OtherINTERNAL ID-MOTOR VEHICLE ID

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031226000141 WA Practitioner - Clinical Psychologist 9133027352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

12033 NE 130TH LN
Suite 120
Kirkland, WA 98034-3052
Phone (425) 899-2160

12039 NE 128TH St
Kirkland, WA 98034-3029

8980 161St Ave NE
Redmond, WA 98052-7554

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.73 of 100Reported as apm
Quality
73.46
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY00002299WAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No. 2 CurrentSince Aug 23, 2010 Accepting new patients
King County Public Hospital District No. 2 CurrentSince Aug 23, 2010 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
King County Public Hospital District No 2 Clinical Neuropsychologist Past Accepting new patients
King County Public Hospital District No 2 Past Accepting new patients

Locations

12039 NE 128th St
Ste 200
Kirkland, WA 98034
Phone (425) 899-1960

12040 NE 128th St
#50
Kirkland, WA 98034
Phone (425) 899-1894

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289174400000",
    "number": "1144305962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34036",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241036",
            "telephone_number": "425-899-3292",
            "fax_number": "425-899-3269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12039 NE 128TH ST",
            "address_2": "STE 200",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343030",
            "telephone_number": "425-899-3140",
            "fax_number": "425-899-3670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERMAN",
        "first_name": "KRISTEN",
        "middle_name": "BREWER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2010-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "WA",
            "license": "PY00002299",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00002299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8352932",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERNAL ID-MOTOR VEHICLE ID",
            "identifier": "251940",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.