Individual provider Active NPI

Calvin Horace Knapp III, MD

  • Dermatology Physician
  • Everett, WA
National Provider Identifier
1225533458
Registry record updated Apr 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD61463521 Issued in WA
Practice address
4004 Colby Ave
Everett, WA 98201-6203
Phone
(425) 339-5417
Fax
(425) 339-5429
NPI assigned
Mar 29, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD61463521 WA Primary

Addresses

Primary practice location

4004 Colby Ave
Everett, WA 98201-6203

Mailing address

7600 Evergreen Way
Everett, WA 98203-6421
Phone (206) 860-5414

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
I20231027001791 WA Practitioner - Dermatology 7214282862 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optum Care Washington PLLCGroup PAC ID 6406752153, 684 clinicians

Practice addresses (Care Compare)

8910 Vernon Rd
Lake Stevens, WA 98258-2400
Phone (425) 397-1700

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions93
Skin biopsy56

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Polyclinic CurrentSince Oct 23, 2023 Accepting new patients
The Polyclinic PLLC Dermatology Current Accepting new patients
Optum Care Washington PLLC CurrentSince Oct 23, 2023 Accepting new patients
Optum Care Washington PLLC CurrentSince Oct 23, 2023 Accepting new patients
Optum Care Washington PLLC Current Accepting new patients
The Polyclinic PLLC CurrentSince Oct 23, 2023 Accepting new patients
Optum Care Washington PLLC Past Accepting new patients

Locations

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

4004 Colby Ave
Everett, WA 98201
Phone (425) 317-3641

8910 Vernon Rd
Lake Stevens, WA 98258
Phone (425) 397-1700

1145 Broadway
Seattle, WA 98122

9709 3rd Ave NE
Seattle, WA 98115
Phone (206) 525-5777

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3889/brand/1/csg/1/fhir/r4
  • Direct secure messaging: cknapp81611@direct.tecmc.com

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776384000000",
    "number": "1225533458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 EVERGREEN WAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982036421",
            "telephone_number": "206-860-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4004 COLBY AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982016203",
            "telephone_number": "425-339-5417",
            "fax_number": "425-339-5429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNAPP",
        "first_name": "CALVIN",
        "middle_name": "HORACE",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-29",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD61463521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.