Individual provider Active NPI

Katrina Mae Dipple, M.D.

  • Clinical Biochemical Genetics Physician
  • Seattle, WA
National Provider Identifier
1295755783
Registry record updated Nov 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Biochemical Genetics PhysicianTaxonomy code 207SG0202X
License
A61420 Issued in CA
Practice address
4800 Sand Point Way NE # Oc9.850
Seattle, WA 98105
Phone
(206) 987-2056
Fax
(206) 987-2495
NPI assigned
Jul 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Biochemical Genetics Physician 207SG0202X A61420 CA Primary

Addresses

Primary practice location

4800 Sand Point Way NE # Oc9.850
Seattle, WA 98105

Mailing address

4800 Sand Point Way NE # Oc9.850
Seattle, WA 98105-3901
Phone (206) 987-2056

Other practice location 1

10833 Le Conte Ave
12-441 MDCC
Los Angeles, CA 90095-3075
Phone (310) 825-5904

Other identifiers 1

IdentifierTypeStateIssuer
00A614200MedicaidCA

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
I20161027001935 WA Practitioner - Pediatric Medicine 7719023597 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Yakima Valley Memorial PhysiciansGroup PAC ID 1557391596, 397 clinicians

Practice addresses (Care Compare)

3801 Kern Way
Yakima, WA 98902-6340
Phone (509) 574-3200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A61420CAMDClinical Biochemical Genetics Physician
61420CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Association of CHMC and University Physicians CurrentSince Nov 5, 2016 Accepting new patients
The Association of University Physicians CurrentSince Oct 12, 2016 Accepting new patients
The Association of Chrmc and University Physicians CurrentSince Nov 5, 2016 Accepting new patients
Yakima Valley Memorial Physicians CurrentSince Nov 1, 2018 Accepting new patients
Yakima Valley Memorial Physicians CurrentSince Nov 1, 2018 Accepting new patients
UCLA Medical Group Past Accepting new patients
Seattle Children's Hospital Past Accepting new patients

Locations

900 Pacific Ave
Ste 100
Everett, WA 98201
Phone (425) 304-6080

4800 Sand Point Way NE
#9850
Seattle, WA 98105
Phone (206) 987-1389

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000

2811 Tieton Dr
Yakima, WA 98902
Phone (509) 249-5210

3801 Kern Rd
Yakima, WA 98902
Phone (509) 574-3200

Interoperability endpoints

  • Direct secure messaging: kdipple35845@direct.seattlechildrens.org
  • Direct secure messaging: kdipple427783@direct.multicare.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543363200000",
    "number": "1295755783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 SAND POINT WAY NE # OC9.850",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981053901",
            "telephone_number": "206-987-2056",
            "fax_number": "206-987-2495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 SAND POINT WAY NE # OC9.850",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98105",
            "telephone_number": "206-987-2056",
            "fax_number": "206-987-2495"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10833 Le Conte Ave",
            "address_2": "12-441 MDCC",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900953075",
            "country_code": "US",
            "telephone_number": "310-825-5904",
            "fax_number": "310-206-8616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIPPLE",
        "first_name": "KATRINA",
        "middle_name": "MAE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2018-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SG0202X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Biochemical Genetics",
            "state": "CA",
            "license": "A61420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A614200",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.