Individual provider Active NPI

Lindsay Marie Nofziger, NP

  • Nurse Practitioner
  • Renton, WA
National Provider Identifier
1306365598
Registry record updated Jun 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP60794615 Issued in WA
Practice address
4033 Talbot Rd S Ste 570
Renton, WA 98055
Phone
(425) 690-3489
Fax
(425) 690-9089
NPI assigned
Sep 19, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN60671576 WA
Gerontology Registered Nurse 163WG0600X RN60671576 WA
Gerontology Nurse Practitioner 363LG0600X AP60794615 WA
Nurse Practitioner 363L00000X AP60794615 WA Primary

Addresses

Primary practice location

4033 Talbot Rd S Ste 570
Renton, WA 98055

Mailing address

3600 Lind Ave SW
Suite 100 Attn Credentialing
Renton, WA 98057-4970
Phone (425) 690-2715

Other identifiers 1

IdentifierTypeStateIssuer
2093776MedicaidWA

Other names 1

  • Lindsay Marie Gossack Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180109002921 WA Practitioner - Nurse Practitioner 6406115971 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Overlake Medical Clinics LLCGroup PAC ID 7012808827, 423 clinicians

Practice addresses (Care Compare)

1750 112TH Ave NE
Suite B102
Bellevue, WA 98004-3772
Phone (425) 688-5460

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN60671576WAMDGerontology Registered Nurse
AP60794615WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Overlake Medical Clinics, LLC Current Accepting new patients
Valley Medical Group-Renton Nurse Practitioner CurrentSince Oct 1, 2019 Accepting new patients
Overlake Medical Clinics LLC CurrentSince Jun 17, 2024 Accepting new patients

Locations

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

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

16850 SE 272nd St
Ste 100
Covington, WA 98042
Phone (253) 395-1971

290 Central Way
Kirkland, WA 98033
Phone (425) 635-6470

4033 Talbot Rd S
Ste 570
Renton, WA 98055
Phone (425) 656-5400

3600 Lind Ave SW
Ste 100
Renton, WA 98057

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1505779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593043200000",
    "number": "1306365598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 LIND AVE SW",
            "address_2": "SUITE 100 ATTN CREDENTIALING",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980574970",
            "telephone_number": "425-690-2715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4033 TALBOT RD S STE 570",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "98055",
            "telephone_number": "425-690-3489",
            "fax_number": "425-690-9089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOFZIGER",
        "first_name": "LINDSAY",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-19",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60671576",
            "primary": false
        },
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "WA",
            "license": "RN60671576",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WA",
            "license": "AP60794615",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60794615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2093776",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDSAY",
            "last_name": "GOSSACK",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.