Individual provider Active NPI

Sarah Elise Petricca, M.D.

  • Internal Medicine Physician
  • Kirkland, WA
National Provider Identifier
1316103583
Registry record updated Oct 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD 60222017 Issued in WA
Practice address
12040 NE 128TH St # Ms 105
Kirkland, WA 98034-3013
Phone
(425) 899-2560
NPI assigned
Aug 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ML60019673 WA
Internal Medicine Physician 207R00000X MD 60222017 WA Primary

Addresses

Primary practice location

12040 NE 128TH St # Ms 105
Kirkland, WA 98034-3013

Mailing address

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

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
I20110903000021 WA Practitioner - Internal Medicine 5496925265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Emory University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
King County Public Hospital District No 2Group PAC ID 7618880097, 586 clinicians

Practice addresses (Care Compare)

12033 NE 130TH LN
Suite 120
Kirkland, WA 98034-3052
Phone (425) 899-2160

12040 NE 128TH St
Kirkland, WA 98034-3013

12040 NE 128TH St Ms
Suite 55
Kirkland, WA 98034-3013

Hospital & facility affiliations

  • Evergreenhealth Medical Center Hospital, Kirkland, WA, CCN 500124
  • Fred Hutchinson Cancer Center Hospital, Seattle, WA, CCN 500138

Merit-based Incentive Payment System (MIPS)

Final score
86.73 of 100Reported as apm
Quality
73.46
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD 60222017WAMDInternal Medicine Physician
ML60019673WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No. 2 CurrentSince Jul 26, 2011 Accepting new patients
King County Public Hospital District No 2 Internal Medicine CurrentSince Jul 26, 2011 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients

Locations

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

12040 NE 128th St
#105
Kirkland, WA 98034
Phone (425) 899-2560

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

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 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": "1217980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319932800000",
    "number": "1316103583",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12040 NE 128TH ST # MS 105",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343013",
            "telephone_number": "425-899-2560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRICCA",
        "first_name": "SARAH",
        "middle_name": "ELISE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-06",
        "last_updated": "2011-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "ML60019673",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD 60222017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.