NPIMap

Individual provider Active NPI

Kenneth Alan Meckler, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Seattle, WA
National Provider Identifier
1174505226
Registry record updated Jun 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
MD00036844 Issued in WA
Practice address
1001 Klickitat Way SW
#205
Seattle, WA 98134
Phone
(206) 622-7747
Fax
(206) 467-1470
NPI assigned
Nov 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD00036844 WA Primary

Addresses

Primary practice location

1001 Klickitat Way SW
#205
Seattle, WA 98134

Mailing address

PO Box 34245
Seattle, WA 98124-1245
Phone (206) 622-7747

Other identifiers 2

IdentifierTypeStateIssuer
125693OtherWAST LABOR AND INDUSTRIES
8242026MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, AK, AZ3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20101018000945 WA Practitioner - Pathology 7012960867 Reassigns benefits to 2 organizations
I20201109001012 AK Practitioner - Pathology 7012960867 Reassigns benefits to 1 organization
I20260330002348 AZ Practitioner - Pathology 7012960867 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Tufts University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cellnetix Pathology PLLCGroup PAC ID 8224062971, shared by 3 NPIs, 58 clinicians

Practice addresses (Care Compare)

1124 Columbia St
Suite 200
Seattle, WA 98104-2048
Phone (206) 386-2676

1601 W Saint Marys Rd
Tucson, AZ 85745-2623
Phone (844) 344-4209

2490 S Woodworth Loop
Suite 410
Palmer, AK 99645-7411
Phone (807) 745-8100

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Polyclinic PLLC Current Accepting new patients
Cellnetix Pathology, PLLC Anatomic Pathology & Clinical Pathology CurrentSince Apr 1, 2017 Accepting new patients
Cellnetix Pathology, PLLC Anatomic Pathology & Clinical Pathology CurrentSince Apr 1, 2017 Accepting new patients
The Polyclinic CurrentSince Feb 10, 2022 Accepting new patients
Cellnetix Pathology, PLLC Anatomic Pathology & Clinical Pathology CurrentSince Sep 15, 2020 Accepting new patients
The Polyclinic PLLC CurrentSince Feb 10, 2022 Accepting new patients
Cellnetix Pathology, PLLC Anatomic Pathology & Clinical Pathology Current Accepting new patients
Puget Sound Institute of Pathology Tacoma Inc PastSince Feb 23, 2005 Accepting new patients

Locations

2490 S Woodworth Loop
Ste 410
Palmer, AK 99645
Phone (807) 745-8100

1171 W Target Range Rd
Nogales, AZ 85621
Phone (520) 285-3000

1601 W Saint Marys Rd
Tucson, AZ 85745
Phone (520) 622-5833

1321 Colby Ave
Everett, WA 98201
Phone (425) 259-4413

1001 SW Klickitat Way
Ste 205
Seattle, WA 98134
Phone (206) 622-7747

1124 Columbia St
Ste 200
Seattle, WA 98104
Phone (206) 576-6050

1145 Broadway
Seattle, WA 98122

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

1780 NW Myhre Rd
Ste 1240
Silverdale, WA 98383
Phone (360) 337-8915

800 W 5th Ave
Spokane, WA 99204
Phone (509) 458-5800

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3889/brand/1/csg/1/fhir/r4

Organizations & group practices 8

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 9

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": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340236800000",
    "number": "1174505226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34245",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241245",
            "telephone_number": "206-622-7747",
            "fax_number": "206-467-1470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 KLICKITAT WAY SW",
            "address_2": "#205",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98134",
            "telephone_number": "206-622-7747",
            "fax_number": "206-467-1470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MECKLER",
        "first_name": "KENNETH",
        "middle_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-15",
        "last_updated": "2012-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WA",
            "license": "MD00036844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ST LABOR AND INDUSTRIES",
            "identifier": "125693",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8242026",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.