Individual provider Active NPI

Rachel Leah Ellenbogen, MD

  • Family Medicine Physician
  • Seattle, WA
National Provider Identifier
1235628611
Registry record updated Feb 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD61466903 Issued in WA
Practice address
4915 25TH Ave NE Ste 300W
Seattle, WA 98105-5668
Phone
(206) 525-7777
NPI assigned
May 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD61466903 WA Primary

Addresses

Primary practice location

4915 25TH Ave NE Ste 300W
Seattle, WA 98105-5668

Mailing address

PO Box 50095
Seattle, WA 98145-5095

Other practice location 1

1959 NE Pacific St.
Seattle, WA 98195-0001
Phone (206) 520-5000

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
I20240203000213 WA Practitioner - Family Practice 4385997311 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Association of University PhysiciansGroup PAC ID 0446162697, 3,484 clinicians
Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

1959 NE Pacific St
Seattle, WA 98195-0001
Phone (206) 598-4333

2600 Compass Rd
Glenview, IL 60026-8001

Hospital & facility affiliations

  • University of Washington Medical Ctr Hospital, Seattle, WA, CCN 500008

Merit-based Incentive Payment System (MIPS)

Final score
93.85 of 100Reported as apm
Quality
74.6
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD61466903WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Association of University Physicians Family Medicine CurrentSince Jan 22, 2024 Accepting new patients

Locations

4915 25th Ave NE
Ste 300W
Seattle, WA 98105
Phone (206) 520-1606

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

Interoperability endpoints

  • Direct secure messaging: rellenbogen236430@direct.ehre.uwmedicine.org
  • Direct secure messaging: rellenbogen137832@direct.urmc.rochester.edu

Organizations & group practices 2

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": "1525132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708128000000",
    "number": "1235628611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4915 25TH AVE NE STE 300W",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981055668",
            "telephone_number": "206-525-7777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1959 NE PACIFIC ST.",
            "address_purpose": "LOCATION",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981950001",
            "country_code": "US",
            "telephone_number": "206-520-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLENBOGEN",
        "first_name": "RACHEL",
        "middle_name": "LEAH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-01",
        "last_updated": "2024-02-17",
        "certification_date": "2024-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61466903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.