Individual provider Active NPI

David Mason Siebert

  • Family Medicine Physician
  • Seattle, WA
National Provider Identifier
1174866354
Registry record updated Aug 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60584255 Issued in WA
Practice address
3800 Montlake Blvd NE
Seattle, WA 98195-8021
Phone
(206) 598-3294
NPI assigned
Apr 5, 2013
Last updated
Aug 7, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X MD60584255 WA
Family Medicine Physician 207Q00000X MD60584255 WA Primary

Addresses

Primary practice location

3800 Montlake Blvd NE
Seattle, WA 98195-8021

Mailing address

3800 Montlake Blvd NE
Seattle, WA 98195
Phone (206) 598-3294

Other practice location 1

314 NE Thornton Pl
Seattle, WA 98125-9000
Phone (206) 528-8000

Other identifiers 1

IdentifierTypeStateIssuer
1174866354MedicaidWA

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
I20170710001023 WA Practitioner - Family Practice 5294050837 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Chicago, Pritzker School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Association of University PhysiciansGroup PAC ID 0446162697, 3,484 clinicians
Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

1959 NE Pacific St
Seattle, WA 98195-0001
Phone (206) 598-4333

2600 Compass Rd
Glenview, IL 60026-8001

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.85 of 100Reported as apm
Quality
74.6
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Association of University Physicians Family Medicine CurrentSince Jul 1, 2017 Accepting new patients
University of Washington Past Accepting new patients

Locations

3800 Montlake Blvd
Seattle, WA 98195
Phone (206) 598-1534

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

Interoperability endpoints

  • Direct secure messaging: dsiebert225572@direct.ehre.uwmedicine.org

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, 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": "1365120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596758400000",
    "number": "1174866354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 MONTLAKE BLVD NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98195",
            "telephone_number": "206-598-3294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 MONTLAKE BLVD NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981958021",
            "telephone_number": "206-598-3294"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "314 NE Thornton Pl",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981259000",
            "country_code": "US",
            "telephone_number": "206-528-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIEBERT",
        "first_name": "DAVID",
        "middle_name": "MASON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-05",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "WA",
            "license": "MD60584255",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60584255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174866354",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.