Mercer Island Foot and Ankle Clinic PLLC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

PO730 Issued in WA

Legal business name

MERCER ISLAND FOOT AND ANKLE CLINIC PLLC

Practice address

3236 78TH Avenue SE
#201
Mercer Island, WA 98040

Phone

(206) 275-9117

Fax

(206) 275-3693

NPI assigned

Nov 6, 2006

Last updated

Jun 16, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mak S Abulhosn, DPMNPI 1356524060

Title

Podiatrist

Phone

(206) 275-9117

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mak Sami Abulhosn, DPM

  • Podiatrist
  • Mercer Island, WA
  • NPI 1356524060
  Medicare reassignment NPD Authorized official
• Aleksey Kozlov, DPM

  • Foot & Ankle Surgery Podiatrist
  • Seattle, WA
  • NPI 1851933253
  Medicare reassignment NPD

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1275612483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3236 78TH AVENUE SE",
            "address_2": "#201",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "98040",
            "telephone_number": "206-275-9117",
            "fax_number": "206-275-3693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3236 78TH AVENUE SE",
            "address_2": "#201",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "98040",
            "telephone_number": "206-275-9117",
            "fax_number": "206-275-3693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCER ISLAND FOOT AND ANKLE CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "ABULHOSN",
        "authorized_official_first_name": "MAK",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "206-275-9117",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "WA",
            "license": "PO730",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DG4542",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7130693",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BCBS",
            "identifier": "3488AB",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Krista Lynn Meeks, ARNP
• Mercer Island Acupuncture & Oriental Medicine
• Mercer Island Dermatology PLLC
• Mercer Island Eyeworks Inc (Mercer Island Eyeworks)
• Mercer Island Family Medicine, PLLC
• Mercer Island Health and Wellness
• Mercer Island Medical Imaging, LLC
• Mercer Island Pediatric Associates
• Mercer Island Pediatric Dentistry
• Mercer Island Psychology

• Podiatrist in Mercer Island, WA
• Providers in Mercer Island, WA by specialty
• Podiatrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.