Individual provider Active NPI

Annamarie Mackey, MD

  • Family Medicine Physician
  • Edmonds, WA
National Provider Identifier
1205193315
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60487160 Issued in WA
Practice address
21911 76TH Ave W Ste 110
Edmonds, WA 98026-7918
Phone
(425) 640-4950
Fax
(425) 640-4958
NPI assigned
Apr 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

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 MD60487160 WA Primary

Addresses

Primary practice location

21911 76TH Ave W Ste 110
Edmonds, WA 98026-7918

Mailing address

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

Other practice location 1

125 16th Ave E
Suite CSB 5
Seattle, WA 98112-5211
Phone (206) 326-3530

Other identifiers 1

IdentifierTypeStateIssuer
1205193315MedicaidWA

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
I20150902001904 WA Practitioner - Family Practice 9436470747 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Washington School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Swedish Health ServicesGroup PAC ID 9537072814, 384 clinicians

Practice addresses (Care Compare)

21911 76TH Ave W
Suite 110
Edmonds, WA 98026-7918
Phone (425) 640-4950

Hospital & facility affiliations

  • Swedish Edmonds Hospital Hospital, Edmonds, WA, CCN 500026

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborcare Health CurrentSince Nov 30, 2015 Accepting new patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Jul 23, 2015 Accepting new patients
Swedish Health Services CurrentSince Nov 1, 2019 Accepting new patients
Swedish Health Services Family Medicine CurrentSince Nov 1, 2019 Accepting new patients
Neighborcare Health CurrentSince Nov 30, 2015 Accepting new patients
Neighborcare Health Current Accepting new patients
Kaiser Foundation Health Plan of Washington Family Medicine CurrentSince Jul 23, 2015 Accepting new patients
Swedish Edmonds Past Accepting new patients

Locations

21911 76th Ave W
Ste 110
Edmonds, WA 98026
Phone (425) 640-4950

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

9245 Rainier Ave S
Seattle, WA 98118
Phone (206) 461-6981

125 16th Ave E
Seattle, WA 98112
Phone (206) 326-3530

12721 30th Ave NE
Ste 101
Seattle, WA 98125
Phone (206) 417-0326

6020 35th Ave SW
Seattle, WA 98126
Phone (206) 461-6950

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

2450 33rd Ave W
Ste 100
Seattle, WA 98199
Phone (206) 320-3364

800 5th Ave
Ste 600
Seattle, WA 98104

4400 37th Ave S
Seattle, WA 98118
Phone (206) 296-4650

1629 N 45th St
Seattle, WA 98103
Phone (206) 633-3350

125 16th Ave E
Ste Csb
Seattle, WA 98112
Phone (206) 326-2555

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Organizations & group practices 9

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": "1334275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1205193315",
    "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": "21911 76TH AVE W STE 110",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267918",
            "telephone_number": "425-640-4950",
            "fax_number": "425-640-4958"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 16th Ave E",
            "address_2": "Suite CSB 5",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981125211",
            "country_code": "US",
            "telephone_number": "206-326-3530",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACKEY",
        "first_name": "ANNAMARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-13",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60487160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1205193315",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

Verify at the official NPI Registry.