Individual provider Active NPI

Kimberly Ann Madsen, MD

  • Ophthalmology Physician
  • Federal Way, WA
National Provider Identifier
1265556120
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD16399 Issued in HI
Practice address
301 S 320TH St
Federal Way, WA 98003-5200
Phone
(253) 874-7958
NPI assigned
Mar 18, 2007
Last updated
Apr 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD16399 HI Primary

Addresses

Primary practice location

301 S 320TH St
Federal Way, WA 98003-5200

Mailing address

301 S 320TH St
Federal Way, WA 98003-5200
Phone (253) 874-7958

Other practice location 1

75-167 Hualalai Rd
Suite 102
Kailua Kona, HI 96740-1714
Phone (808) 329-2010

Other identifiers 2

IdentifierTypeStateIssuer
690900MedicaidHI
P01078149OtherHIRR MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync Health Information Exchange (HIE)

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
I20191125000215 WA Practitioner - Ophthalmology 3678611480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Ohio State University College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

301 S 320TH St
Federal Way, WA 98003-5200
Phone (253) 874-7000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery22

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD16399HIMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince Oct 1, 2019 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Oct 1, 2019 Accepting new patients

Locations

301 S 320th St
Federal Way, WA 98003
Phone (253) 874-7000

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

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

Interoperability endpoints

  • Direct secure messaging: kmadsen232877@ghc.direct-ci.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1265556120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S 320TH ST",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980035200",
            "telephone_number": "253-874-7958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 S 320TH ST",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980035200",
            "telephone_number": "253-874-7958"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75-167 Hualalai Rd",
            "address_2": "Suite 102",
            "address_purpose": "LOCATION",
            "city": "Kailua Kona",
            "state": "HI",
            "postal_code": "967401714",
            "country_code": "US",
            "telephone_number": "808-329-2010",
            "fax_number": "808-329-2530",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MADSEN",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-18",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "HI",
            "license": "MD16399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "690900",
            "state": "HI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01078149",
            "state": "HI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "301 S 320th St",
            "city": "Federal Way",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980035200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

Verify at the official NPI Registry.