Individual provider Active NPI

David Ege, MD

  • Pediatrics Physician
  • Issaquah, WA
National Provider Identifier
1295916559
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
29579 Issued in WA
Practice address
450 NW Gilman Blvd Ste 201
Issaquah, WA 98027-2483
Phone
(425) 391-0705
Fax
(424) 391-9562
NPI assigned
Nov 15, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 29579 WA Primary

Addresses

Primary practice location

450 NW Gilman Blvd Ste 201
Issaquah, WA 98027-2483

Mailing address

450 NW Gilman Blvd Ste 201
Issaquah, WA 98027-2483
Phone (425) 391-0705

Other practice location 1

751 NE Blakely Dr Ste 5010
Issaquah, WA 98029-6201
Phone (425) 313-7141

Other identifiers 1

IdentifierTypeStateIssuer
AB32503MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dege1041535@wm.providencedirect.org Direct

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
I20111227000806 WA Practitioner - Pediatric Medicine 4981870847 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
29579WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Health Services Pediatrics CurrentSince Oct 9, 2013 Accepting new patients
Swedish Health Services CurrentSince Oct 9, 2013 Accepting new patients
Swedish Health Services Past Accepting new patients

Locations

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

751 NE Blakely Dr
Ste 5010
Issaquah, WA 98029
Phone (425) 394-0700

800 5th Ave
Ste 600
Seattle, WA 98104

2450 33rd Ave W
Ste 100
Seattle, WA 98199
Phone (206) 320-3364

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

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, 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": "1195084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1295916559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 NW GILMAN BLVD STE 201",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272483",
            "telephone_number": "425-391-0705",
            "fax_number": "425-391-9562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 NW GILMAN BLVD STE 201",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272483",
            "telephone_number": "425-391-0705",
            "fax_number": "424-391-9562"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "751 NE Blakely Dr Ste 5010",
            "address_purpose": "LOCATION",
            "city": "Issaquah",
            "state": "WA",
            "postal_code": "980296201",
            "country_code": "US",
            "telephone_number": "425-313-7141",
            "fax_number": "425-394-0757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EGE",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-15",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "29579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AB32503",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dege1041535@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "751 NE Blakely Dr Ste 5010",
            "city": "Issaquah",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980296201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

Verify at the official NPI Registry.