Active NPI
Susanna R Mirel, ARNP
- Pediatric Nurse Practitioner
- Bellevue, WA
National Provider Identifier
1215222591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- AP60223340
- Practice address
- 13451 SE 36TH St
Bellevue, WA 98006-1475 - Phone
- (425) 562-1337
- Fax
- (425) 562-1331
- NPI assigned
- Jun 14, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | AP60223340 | WA | Primary |
Addresses
Primary practice location
13451 SE 36TH St
Bellevue, WA 98006-1475
Mailing address
971 11TH Ave
Longview, WA 98632-2503
Phone (360) 577-1771
Other names 1
- Shoshana R Mirel
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP60223340 | WA | MD | Pediatric Nurse Practitioner |
Interoperability endpoints
- smirel153136@ghc.direct-ci.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618963200000",
"number": "1215222591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "971 11TH AVE",
"city": "LONGVIEW",
"state": "WA",
"postal_code": "986322503",
"telephone_number": "360-577-1771",
"fax_number": "360-423-1405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13451 SE 36TH ST",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980061475",
"telephone_number": "425-562-1337",
"fax_number": "425-562-1331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIREL",
"first_name": "SUSANNA",
"middle_name": "R",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-14",
"last_updated": "2021-04-21",
"certification_date": "2021-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "WA",
"license": "AP60223340",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
"affiliation": "N",
"endpointDescription": "Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "13451 SE 36th St",
"city": "Bellevue",
"state": "WA",
"country_code": "US",
"postal_code": "980061475",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "SHOSHANA",
"last_name": "MIREL",
"middle_name": "R",
"credential": "ARNP",
"code": "5",
"type": "Other Name"
}
]
}
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 Apr 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.