Individual provider Active NPI

Kathryn Mitsuko Mayeda Gossett, PA-C

  • Surgical Physician Assistant
  • Bellevue, WA
National Provider Identifier
1235533795
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA60511076 Issued in WA
Practice address
3101 Northup Way Ste 201
Bellevue, WA 98004-1449
Phone
(425) 455-3600
Fax
(425) 455-3920
NPI assigned
Oct 13, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA60511076 WA
Surgical Physician Assistant 363AS0400X PA60511076 WA Primary

Addresses

Primary practice location

3101 Northup Way Ste 201
Bellevue, WA 98004-1449

Mailing address

510 8TH Ave NE Ste 320
Issaquah, WA 98029-5436
Phone (425) 455-3600

Other practice location 1

510 8th Ave NE Ste 200
Issaquah, WA 98029-5436
Phone (425) 392-3030

Other practice location 2

515 Minor Ave Ste 200
Seattle, WA 98104-2133
Phone (425) 455-3600

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150630001977 WA Practitioner - Physician Assistant 0941421531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Proliance Surgeons Inc P SGroup PAC ID 8527972900, 395 clinicians

Practice addresses (Care Compare)

18100 NE Union Hill Rd
Redmond, WA 98052-3330
Phone (425) 498-2345

3101 Northup Way
Bellevue, WA 98004-1449

510 8TH Ave NE
Issaquah, WA 98029-5436

751 NE Blakely Dr
Issaquah, WA 98029-6201
Phone (425) 313-5422

Hospital & facility affiliations

  • Overlake Hospital Medical Center & Clinics Hospital, Bellevue, WA, CCN 500051
  • Swedish Issaquah Hospital, Issaquah, WA, CCN 500152

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA60511076WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc P S Surgical CurrentSince Oct 1, 2019 Accepting new patients
Proliance Surgeons, Inc., P.S. CurrentSince Oct 1, 2019 Accepting new patients
Overlake Internal Medicine Laboratory PastSince Jul 25, 2019 Accepting new patients

Locations

3101 Northup Way
Ste 201
Bellevue, WA 98004
Phone (425) 455-3600

1231 116th Ave NE
Ste 750
Bellevue, WA 98004
Phone (425) 455-3600

510 8th Ave NE
Ste 200
Issaquah, WA 98029
Phone (425) 392-3030

515 Minor Ave
Ste 200
Seattle, WA 98104
Phone (206) 386-9615

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

Interoperability endpoints

  • Direct secure messaging: kathryn.mayeda@1457.chartlogic.direct-ci.com

Organizations & group practices 4

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 3

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": "1413158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1235533795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 8TH AVE NE STE 320",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980295436",
            "telephone_number": "425-455-3600",
            "fax_number": "425-455-3920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 NORTHUP WAY STE 201",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980041449",
            "telephone_number": "425-455-3600",
            "fax_number": "425-455-3920"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 8th Ave NE Ste 200",
            "address_purpose": "LOCATION",
            "city": "Issaquah",
            "state": "WA",
            "postal_code": "980295436",
            "country_code": "US",
            "telephone_number": "425-392-3030",
            "fax_number": "425-392-2564",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "515 Minor Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981042133",
            "country_code": "US",
            "telephone_number": "425-455-3600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOSSETT",
        "first_name": "KATHRYN",
        "middle_name": "MITSUKO MAYEDA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-13",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60511076",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA60511076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.