Individual provider Active NPI

Teresa J Pliskowski

  • Family Medicine Physician
  • Everett, WA
National Provider Identifier
1245384734
Registry record updated Feb 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00046863 Issued in WA
Practice address
12800 Bothell-Everett Hwy
Everett, WA 98208-6642
Phone
(425) 316-5150
NPI assigned
Jan 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2015

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 MD00046863 WA Primary

Addresses

Primary practice location

12800 Bothell-Everett Hwy
Everett, WA 98208-6642

Mailing address

PO Box 3360
Portland, OR 97208-3360
Phone (866) 366-2983

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
I20080204000216 WA Practitioner - Family Practice 0042392722 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Overlake Medical Clinics LLCGroup PAC ID 7012808827, 423 clinicians

Practice addresses (Care Compare)

17209 Redmond Way
Redmond, WA 98052-4404
Phone (425) 635-6400

1750 112TH Ave NE
Suite B102
Bellevue, WA 98004-3772
Phone (425) 688-5460

5708 E Lake Samm Pkwy SE
Issaquah, WA 98029-8942
Phone (425) 688-5488

Hospital & facility affiliations

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

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
MD00046863WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince Jan 1, 2007 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Jan 1, 2007 Accepting new patients
Overlake Medical Clinics LLC CurrentSince Dec 8, 2014 Accepting new patients
Overlake Medical Clinics, LLC CurrentSince Dec 8, 2014 Accepting new patients
Issaquah Obstetrics and Gynecology PLLC Past Accepting new patients

Locations

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

10223 NE 10th St
Bellevue, WA 98004
Phone (425) 453-3288

5708 E Lake Sammamish Pkwy SE
Ste 102
Issaquah, WA 98029
Phone (425) 688-5488

6520 226th Pl SE
Ste 150
Issaquah, WA 98027
Phone (425) 688-5777

17209 Redmond Way
Redmond, WA 98052
Phone (425) 635-6400

125 16th Ave E
Seattle, WA 98112
Phone (206) 326-3530

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Organizations & group practices 5

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 2

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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424736000000",
    "number": "1245384734",
    "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": "866-366-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12800 BOTHELL-EVERETT HWY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982086642",
            "telephone_number": "425-316-5150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLISKOWSKI",
        "first_name": "TERESA",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2015-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00046863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.