NPIMap

Individual provider Active NPI

Ann Smith

  • Emergency Medicine Physician
  • Bellevue, WA
National Provider Identifier
1295120715
Registry record updated Dec 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD61188455 Issued in WA
Practice address
1035 116TH Ave NE
Bellevue, WA 98004-4604
Phone
(425) 688-5100
NPI assigned
Apr 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2018-00971 NC
Emergency Medicine Physician 207P00000X MD61188455 WA Primary

Addresses

Primary practice location

1035 116TH Ave NE
Bellevue, WA 98004-4604

Mailing address

1035 116TH Ave NE
Bellevue, WA 98004-4604

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20181011002895 NC Practitioner - Emergency Medicine 0547577017 Reassigns benefits to 1 organization
I20210805002047 WA Practitioner - Emergency Medicine 0547577017 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Albany Medical College of Union University, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Puget Sound Physicians PLLCGroup PAC ID 2961301882, 47 clinicians

Practice addresses (Care Compare)

1035 116TH Ave NE
Bellevue, WA 98004-4604
Phone (425) 688-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.26 of 100Reported as group
Quality
95.59
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
83.74 of 100Reported as group
Quality
78.83
Promoting interoperability
100
Improvement activities
40
Cost
66.97

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD61188455WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital District No 4 King County Washington CurrentSince Sep 1, 2021 Accepting new patients
Overlake Medical Clinics, LLC Current Accepting new patients
Puget Sound Physicians PLLC Emergency Medicine CurrentSince Aug 20, 2021 Accepting new patients
Overlake Medical Clinics LLC CurrentSince Apr 16, 2023 Accepting new patients
Public Hospital District No 4 King County Washington CurrentSince Sep 1, 2021 Accepting new patients
Wake Forest Emergency Providers CurrentSince Sep 1, 2019 Accepting new patients
Public Hospital District No 4, King County Wa Past Accepting new patients

Locations

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

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

3011 196th St SW
Lynnwood, WA 98036
Phone (425) 688-5759

9801 Frontier Ave SE
Snoqualmie, WA 98065
Phone (425) 831-2300

Organizations & group practices 7

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 3

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": "1427846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670198400000",
    "number": "1295120715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 116TH AVE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 116TH AVE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044604",
            "telephone_number": "425-688-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-01",
        "last_updated": "2022-12-05",
        "certification_date": "2022-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2018-00971",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD61188455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.