Individual provider Active NPI

Yancy Marc Bellis, M.D.

  • Emergency Medicine Physician
  • Bellevue, WA
National Provider Identifier
1154357127
Registry record updated Jun 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD00042265 Issued in WA
Practice address
1035 116TH Ave NE
Bellevue, WA 98004-4604
Phone
(425) 688-5000
NPI assigned
Jun 23, 2006
Last updated
Jun 18, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD00042265 WA Primary

Addresses

Primary practice location

1035 116TH Ave NE
Bellevue, WA 98004-4604

Mailing address

PO Box 34960
Seattle, WA 98124-1960
Phone (425) 656-4255

Other identifiers 1

IdentifierTypeStateIssuer
8352171MedicaidWA

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
I20040408000919 WA Practitioner - Emergency Medicine 2163318254 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of New Mexico School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Puget Sound Physicians PLLCGroup PAC ID 2961301882, 47 clinicians

Practice addresses (Care Compare)

1035 116TH Ave NE
Bellevue, WA 98004-4604
Phone (425) 688-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.26 of 100Reported as group
Quality
95.59
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00042265WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital District No 4, King County Wa Past Accepting new patients
Good Samaritan Hospital Emergency Medicine Past Accepting new patients
Mt. Rainier Emergency Physicians, PLLC Emergency Medicine PastSince Mar 26, 2023 Accepting new patients
Overlake Medical Clinics LLC Past Accepting new patients

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 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": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339977600000",
    "number": "1154357127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34960",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241960",
            "telephone_number": "425-656-4255",
            "fax_number": "425-656-4003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 116TH AVE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044604",
            "telephone_number": "425-688-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLIS",
        "first_name": "YANCY",
        "middle_name": "MARC",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2012-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD00042265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8352171",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.