Individual provider Active NPI

Mitchell William Hustad, MD

  • Addiction Medicine (Family Medicine) Physician
  • Seattle, WA
National Provider Identifier
1316407034
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
License
MD61190294 Issued in WA
Practice address
1801 NW Market St Ste 207
Seattle, WA 98107-3909
Phone
(206) 320-7288
Fax
(206) 320-7289
NPI assigned
Mar 20, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD61190294 WA
Addiction Medicine (Family Medicine) Physician 207QA0401X MD61190294 WA Primary

Addresses

Primary practice location

1801 NW Market St Ste 207
Seattle, WA 98107-3909

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476

Other practice location 1

1401 Madison St Ste 100
Seattle, WA 98104-1316
Phone (206) 386-6197

Other identifiers 1

IdentifierTypeStateIssuer
2165846MedicaidWA

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
I20230919003531 WA Practitioner - Addiction MedicinePractitioner - Family Practice 3274861109 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Addiction MedicineAlso: Family Practice
Education
Virginia Commonwealth University, School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Swedish Health ServicesGroup PAC ID 0244138196, 1,038 clinicians

Practice addresses (Care Compare)

5300 Tallman Nwave
Seattle, WA 98107-3932
Phone (206) 782-2700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.1 of 100Reported as group
Quality
84.53
Promoting interoperability
100
Improvement activities
40
Cost
72.46

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Health Services Addiction Medicine CurrentSince Sep 11, 2023 Accepting new patients
Swedish Health Services Past Accepting new patients

Locations

7320 216th St SW
Ste 310
Edmonds, WA 98026
Phone (425) 673-3800

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

1401 Madison St
Ste 100
Seattle, WA 98104
Phone (206) 386-6111

1801 NW Market St
Ste 207
Seattle, WA 98107
Phone (206) 320-7330

5300 Tallman Ave NW
Seattle, WA 98107
Phone (206) 781-6209

Organizations & group practices 2

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 1

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": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1316407034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 NW MARKET ST STE 207",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981073909",
            "telephone_number": "206-320-7288",
            "fax_number": "206-320-7289"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 Madison St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981041316",
            "country_code": "US",
            "telephone_number": "206-386-6197",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUSTAD",
        "first_name": "MITCHELL",
        "middle_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-20",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61190294",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "WA",
            "license": "MD61190294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2165846",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.