NPIMap

Individual provider Active NPI

Katelan Hauck Longfellow, M.D.

  • Neurology Physician
  • Seattle, WA
National Provider Identifier
1245469279
Registry record updated Dec 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MD60385036 Issued in WA
Practice address
1959 NE Pacific St
Seattle, WA 98195-0001
Phone
(206) 543-6420
NPI assigned
Jul 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MD60385036 WA Primary

Addresses

Primary practice location

1959 NE Pacific St
Seattle, WA 98195-0001

Mailing address

18118 26TH Dr SE
Bothell, WA 98012-9315
Phone (425) 354-9846

Other identifiers 1

IdentifierTypeStateIssuer
1245469279MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130718000427 WA Practitioner - Neurology 7012158926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

1608 S J St
FL 5
Tacoma, WA 98405-4930
Phone (253) 274-7505

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60385036WAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group CurrentSince Aug 3, 2015 Accepting new patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Organizations & group practices 3

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 10

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": "1247356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450396800000",
    "number": "1245469279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18118 26TH DR SE",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980129315",
            "telephone_number": "425-354-9846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981950001",
            "telephone_number": "206-543-6420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGFELLOW",
        "first_name": "KATELAN",
        "middle_name": "HAUCK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-12",
        "last_updated": "2015-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WA",
            "license": "MD60385036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245469279",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.