Organization Active NPI

Bellevue Health Clinic, LLC

  • Internal Medicine Physician
  • Bellevue, WA
National Provider Identifier
1205487576
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BELLEVUE HEALTH CLINIC, LLC
Practice address
1417 116TH Ave NE Ste 204
Bellevue, WA 98004-3830
Phone
(425) 298-7771
NPI assigned
Sep 26, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Authorized official

Name
Jihua Jia, MDNPI 1629357744
Title
Governor
Phone
(425) 298-7771

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1417 116TH Ave NE Ste 204
Bellevue, WA 98004-3830

Mailing address

9240 SE Shoreland Dr
Bellevue, WA 98004-6519
Phone (425) 298-7771

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200313000886 WA Part B Supplier - Clinic/Group Practice 9830527431 Receives reassigned benefits from 1 practitioner
Practice locations: Bellevue, WA

National Provider Directory

National Provider Directory

Locations

1417 116th Ave NE
Ste 204
Bellevue, WA 98004
Phone (425) 298-7771

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1569456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735516800000",
    "number": "1205487576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9240 SE SHORELAND DR",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980046519",
            "telephone_number": "425-298-7771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 116TH AVE NE STE 204",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043830",
            "telephone_number": "425-298-7771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLEVUE HEALTH CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-26",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A",
        "authorized_official_last_name": "JIA",
        "authorized_official_first_name": "JIHUA",
        "authorized_official_title_or_position": "GOVERNOR",
        "authorized_official_telephone_number": "425-298-7771",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.