Individual provider Active NPI

Nelly Bardman, M.D.

  • Internal Medicine Physician
  • Bellevue, WA
National Provider Identifier
1326117300
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD 00044878 Issued in WA
Practice address
15710 NE 24TH St Ste C
Bellevue, WA 98008-2444
Phone
(425) 208-0026
Fax
(425) 644-3868
NPI assigned
Nov 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD 00044878 WA Primary

Addresses

Primary practice location

15710 NE 24TH St Ste C
Bellevue, WA 98008-2444

Mailing address

15710 NE 24TH St Ste C
Bellevue, WA 98008-2444
Phone (425) 208-0026

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
I20060302000481 WA Practitioner - Internal Medicine 7517973365

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
U.S. Healthworks Medical Group of Washington, PS Past Accepting new patients

Organizations & group practices 1

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": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1326117300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15710 NE 24TH ST STE C",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980082444",
            "telephone_number": "425-208-0026",
            "fax_number": "425-644-3868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15710 NE 24TH ST STE C",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980082444",
            "telephone_number": "425-208-0026",
            "fax_number": "425-644-3868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARDMAN",
        "first_name": "NELLY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD 00044878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.