Individual provider Active NPI

Dustin Mark Hayward, M.D.

  • Neurological Surgery Physician
  • Kirkland, WA
National Provider Identifier
1235395849
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
MD60546371 Issued in WA
Practice address
12039 NE 128TH St Ste 500
Kirkland, WA 98034
Phone
(425) 899-5590
Fax
(425) 899-5588
NPI assigned
Aug 3, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 125055496 IL
Neurological Surgery Physician 207T00000X MD60546371 WA Primary

Addresses

Primary practice location

12039 NE 128TH St Ste 500
Kirkland, WA 98034

Mailing address

PO Box 3360
Portland, OR 97208-3360
Phone (866) 747-2455

Other practice location 1

1321 Colby Ave
Everett, WA 98201-1665
Phone (425) 297-6400

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address dhayward631123@wm.providencedirect.org Direct
Direct Messaging Address dhayward631123@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150810002806 WA Practitioner - Neurosurgery 5193030823 Reassigns benefits to 2 organizations
I20151027001927 TX Practitioner - NeurosurgeryPractitioner - Interventional Radiology 5193030823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of California, San Diego School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

12033 NE 130TH LN
Suite 120
Kirkland, WA 98034-3052
Phone (425) 899-2160

12039 NE 128TH St
Kirkland, WA 98034-3029

12040 NE 128TH St
Kirkland, WA 98034-3013

12040 NE 128TH St Ms
Suite 55
Kirkland, WA 98034-3013

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.73 of 100Reported as apm
Quality
73.46
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125055496ILMDNeurological Surgery Physician
MD60546371WAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Overlake Medical Clinics, LLC CurrentSince Jul 1, 2020 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
Overlake Medical Clinics LLC CurrentSince Jul 1, 2020 Accepting new patients
King County Public Hospital District No. 2 CurrentSince Dec 13, 2017 Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Aug 13, 2015 Accepting new patients
King County Public Hospital District No. 2 CurrentSince Dec 13, 2017 Accepting new patients
King County Public Hospital District No 2 Past Accepting new patients
King County Public Hospital District No. 2 Past Accepting new patients

Locations

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

1750 112th Ave NE
Ste B102
Bellevue, WA 98004
Phone (425) 688-5460

1135 116th Ave NE
Ste 500
Bellevue, WA 98004
Phone (425) 454-3938

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

1321 Colby Ave
Everett, WA 98201
Phone (425) 259-4413

12039 NE 128th St
Ste 500
Kirkland, WA 98034
Phone (425) 899-1220

12040 NE 128th St
#10
Kirkland, WA 98034
Phone (206) 466-0369

12039 NE 128th St
Ste 300
Kirkland, WA 98034
Phone (425) 899-3123

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

Interoperability endpoints

  • Direct secure messaging: dhayward631123@wm.providencedirect.org

Organizations & group practices 8

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 1

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": "1217721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1235395849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360",
            "telephone_number": "866-747-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12039 NE 128TH ST STE 500",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "98034",
            "telephone_number": "425-899-5590",
            "fax_number": "425-899-5588"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1321 Colby Ave",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982011665",
            "country_code": "US",
            "telephone_number": "425-297-6400",
            "fax_number": "425-297-6405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAYWARD",
        "first_name": "DUSTIN",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-03",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "IL",
            "license": "125055496",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "WA",
            "license": "MD60546371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dhayward631123@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "12039 NE 128th St Ste 500",
            "city": "Kirkland",
            "state": "WA",
            "country_code": "US",
            "postal_code": "98034",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dhayward631123@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1321 Colby Ave",
            "city": "Everett",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982011665",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.