Individual provider Active NPI

Eva Doreen Kiss, M.D.

  • Pediatrics Physician
  • Kent, WA
National Provider Identifier
1336101906
Registry record updated Feb 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD00048726 Issued in WA
Practice address
23213 Pacific Hwy S
Kent, WA 98032-2721
Phone
(206) 870-8880
NPI assigned
Apr 6, 2006
Last updated
Feb 7, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD00048726 WA Primary
Pediatric Adolescent Medicine Physician 2080A0000X MD00048726 WA

Addresses

Primary practice location

23213 Pacific Hwy S
Kent, WA 98032-2721

Mailing address

PO Box 50095
Seattle, WA 98145-5095
Phone (206) 543-6420

Other identifiers 1

IdentifierTypeStateIssuer
1336101906MedicaidWA

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
I20080205000117 WA Practitioner - Pediatric Medicine 2062430184 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Association of University Physicians CurrentSince Jul 1, 2009 Accepting new patients

Locations

23213 Pacific Hwy S
Kent, WA 98032
Phone (206) 520-4396

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

2818 NE 145th St
Shoreline, WA 98155
Phone (206) 354-8810

Interoperability endpoints

  • Direct secure messaging: ekiss82766@direct.ehre.uwmedicine.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328572800000",
    "number": "1336101906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095",
            "telephone_number": "206-543-6420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23213 PACIFIC HWY S",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980322721",
            "telephone_number": "206-870-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISS",
        "first_name": "EVA",
        "middle_name": "DOREEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-06",
        "last_updated": "2012-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00048726",
            "primary": true
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "WA",
            "license": "MD00048726",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336101906",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, WA

Sources for this page

Verify at the official NPI Registry.