Individual provider Active NPI

Paul H Dreyfuss, MD

  • Interventional Pain Medicine Physician
  • Kirkland, WA
National Provider Identifier
1306817481
Registry record updated Jun 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
MD00040561 Issued in WA
Practice address
11800 NE 128TH St
Suite 530
Kirkland, WA 98034-7208
Phone
(425) 454-1111
Fax
(425) 454-7653
NPI assigned
Jan 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X MD00040561 WA
Interventional Pain Medicine Physician 208VP0014X MD00040561 WA Primary

Addresses

Primary practice location

11800 NE 128TH St
Suite 530
Kirkland, WA 98034-7208

Mailing address

PO Box 34036
Seattle, WA 98124-1036
Phone (425) 899-3292

Other identifiers 2

IdentifierTypeStateIssuer
8288664MedicaidWA
153759OtherWAL&I #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120125000914 WA Practitioner - Interventional Pain ManagementPractitioner - Physical Medicine and Rehabilitation 6103093570 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No. 2 CurrentSince May 31, 2017 Accepting new patients
King County Public Hospital District No 2 CurrentSince May 31, 2017 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
King County Public Hospital District No 2 Past Accepting new patients

Locations

12301 NE 10th Pl
Ste 101
Bellevue, WA 98005
Phone (425) 420-2663

12040 NE 128th St
#10
Kirkland, WA 98034
Phone (206) 466-0369

12039 NE 128th St
Ste 300
Kirkland, WA 98034
Phone (425) 899-3123

Organizations & group practices 4

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": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340841600000",
    "number": "1306817481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34036",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241036",
            "telephone_number": "425-899-3292",
            "fax_number": "425-899-3269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 NE 128TH ST",
            "address_2": "SUITE 530",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980347208",
            "telephone_number": "425-454-1111",
            "fax_number": "425-454-7653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DREYFUSS",
        "first_name": "PAUL",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2012-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "WA",
            "license": "MD00040561",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "WA",
            "license": "MD00040561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8288664",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I #",
            "identifier": "153759",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.