Individual provider Active NPI

Vincent B Siy, MD

  • Family Medicine Physician
  • Bellevue, WA
National Provider Identifier
1144509423
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD61095140 Issued in WA
Practice address
400 108TH Ave NE
Bellevue, WA 98004
Phone
(425) 635-6350
Fax
(425) 635-6351
NPI assigned
Aug 4, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD166137 OR
Family Medicine Physician 207Q00000X MD61095140 WA Primary

Addresses

Primary practice location

400 108TH Ave NE
Bellevue, WA 98004

Mailing address

Ms 315010
PO Box 3947
Seatle, WA 98124-3947
Phone (425) 467-3655

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210126003280 WA Practitioner - Family Practice 2466692603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Overlake Medical Clinics LLCGroup PAC ID 7012808827, 423 clinicians

Practice addresses (Care Compare)

1035 116TH Ave NE
Bellevue, WA 98004-4604
Phone (425) 688-5072

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 Medicine

State licenses

LicenseStateTypeSpecialty
MD166137ORMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Overlake Medical Clinics LLC CurrentSince Feb 1, 2021 Accepting new patients
Overlake Medical Clinics, LLC Current Accepting new patients
International Community Health Services Family Medicine PastSince Mar 21, 2021 Accepting new patients

Locations

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

10223 NE 10th St
Bellevue, WA 98004
Phone (425) 453-3288

1750 112th Ave NE
Ste B102
Bellevue, WA 98004
Phone (425) 688-5460

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1312416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616025600000",
    "number": "1144509423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MS 315010",
            "address_2": "PO BOX 3947",
            "city": "SEATLE",
            "state": "WA",
            "postal_code": "981243947",
            "telephone_number": "425-467-3655",
            "fax_number": "425-635-6388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 108TH AVE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98004",
            "telephone_number": "425-635-6350",
            "fax_number": "425-635-6351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIY",
        "first_name": "VINCENT",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-04",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD166137",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61095140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.