Individual provider Active NPI

Stephanie Chia, MD

  • Family Medicine Physician
  • Seattle, WA
National Provider Identifier
1194286195
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD61270861 Issued in WA
Practice address
1401 Madison St Ste 100
Seattle, WA 98104-1316
Phone
(206) 386-6111
Fax
(206) 386-6113
NPI assigned
Mar 31, 2019
Last updated
Oct 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD61270861 WA Primary

Addresses

Primary practice location

1401 Madison St Ste 100
Seattle, WA 98104-1316

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476

Other practice location 1

3815 S Othello St Fl 2
Seattle, WA 98118-3510
Phone (206) 788-3500

Other identifiers 1

IdentifierTypeStateIssuer
2212525MedicaidWA

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
I20220721002174 WA Practitioner - Family Practice 1658751219 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Albert Einstein College of Medicine of Yeshiva University, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
International Community Health ServicesGroup PAC ID 5799695672, shared by 7 NPIs, 95 clinicians

Practice addresses (Care Compare)

3815 S Othello St
Seattle, WA 98118-3510
Phone (206) 788-3500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD61270861WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
International Community Health Services Family Medicine CurrentSince Oct 23, 2023 Accepting new patients
International Community Health Services CurrentSince Oct 23, 2023 Accepting new patients
University of Penn-Medical Group PastSince Sep 29, 2019 Accepting new patients
Presbyterian Medical Center of the University of Pennsylvania Health S PastSince Sep 29, 2019 Accepting new patients

Locations

3815 S Othello St
Fl 2
Seattle, WA 98118
Phone (206) 788-3500

720 8th Ave S
Seattle, WA 98104
Phone (206) 788-3757

Organizations & group practices 4

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1194286195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 MADISON ST STE 100",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041316",
            "telephone_number": "206-386-6111",
            "fax_number": "206-386-6113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3815 S Othello St Fl 2",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981183510",
            "country_code": "US",
            "telephone_number": "206-788-3500",
            "fax_number": "206-962-3298",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHIA",
        "first_name": "STEPHANIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-31",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61270861",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2212525",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.