Individual provider Active NPI

Allison Leslie Luedke

  • Physician Assistant
  • Spokane, WA
National Provider Identifier
1235859299
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61480534 Issued in WA
Practice address
510 E Holland Ave
Spokane, WA 99218-1206
Phone
(509) 363-3100
Fax
(509) 363-0300
NPI assigned
Aug 30, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA61480534 WA Primary

Addresses

Primary practice location

510 E Holland Ave
Spokane, WA 99218-1206

Mailing address

701 W Willapa Ave
Spokane, WA 99224-5338
Phone (509) 847-4680

Other practice location 1

701 W Willapa Ave
Spokane, WA 99224-5338
Phone (509) 847-4680

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
I20240808003078 WA Practitioner - Physician Assistant 7113464033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
T Daniel Dibble MD PCGroup PAC ID 1254320922, 12 clinicians

Practice addresses (Care Compare)

1123 N Evergreen Rd
Spokane Valley, WA 99216-1138
Phone 5093633100304

510 E Holland Ave
Spokane, WA 99218-1206
Phone 5093633100304

Hospital & facility affiliations

  • Providence Mount Carmel Hospital Hospital, Colville, WA, CCN 501326

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
T Daniel Dibble MD PC CurrentSince Aug 6, 2024 Accepting new patients

Locations

510 E Holland Ave
Spokane, WA 99218
Phone (509) 363-3100

1123 N Evergreen Rd
Spokane Valley, WA 99216
Phone (509) 363-3100

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": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1235859299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 W WILLAPA AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992245338",
            "telephone_number": "509-847-4680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 E HOLLAND AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992181206",
            "telephone_number": "509-363-3100",
            "fax_number": "509-363-0300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 W Willapa Ave",
            "address_purpose": "LOCATION",
            "city": "Spokane",
            "state": "WA",
            "postal_code": "992245338",
            "country_code": "US",
            "telephone_number": "509-847-4680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUEDKE",
        "first_name": "ALLISON",
        "middle_name": "LESLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-30",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61480534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.