Individual provider Active NPI

Keith T Paige, MD

  • Plastic and Reconstructive Surgery Physician
  • Seattle, WA
National Provider Identifier
1336152180
Registry record updated Jun 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
MD00036238 Issued in WA
Practice address
1229 Madison St
Seattle, WA 98104-3586
Phone
(206) 860-4686
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X MD00036238 WA Primary

Addresses

Primary practice location

1229 Madison St
Seattle, WA 98104-3586

Mailing address

7600 Evergreen Way
Everett, WA 98203-6421
Phone (206) 860-5414

Other identifiers 6

IdentifierTypeStateIssuer
0039572OtherWALABOR & INDUSTRY
MD8236OtherWAALASKA MEDICAID
US1037407OtherWAAETNA/USHC SPECIALIST
240007287OtherRAILROAD MEDICARE
8229619MedicaidWA
PA0297OtherWABLUE SHIELD

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
I20050826000711 WA Practitioner - Plastic and Reconstructive Surgery 6608807862 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Harvard Medical School, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Polyclinic PLLCGroup PAC ID 2163328196, 364 clinicians

Practice addresses (Care Compare)

1145 Broadway
Seattle, WA 98122-4201
Phone (206) 329-1760

1229 Madison St
Suite 1660
Seattle, WA 98104-3586
Phone (206) 860-5582

9709 3Rd Ave NE
Optum Northgate Plaza Urgent Care
Seattle, WA 98104-3586
Phone (206) 401-3191

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy20
Melanoma (skin cancer) excision1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00036238WAMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Polyclinic PLLC Plastic Surgery Current Accepting new patients
The Polyclinic PLLC CurrentSince Jan 1, 2014 Accepting new patients
The Polyclinic PLLC Past Accepting new patients

Locations

1145 Broadway
Seattle, WA 98122

1229 Madison St
Ste 1660
Seattle, WA 98104
Phone (206) 860-5582

Interoperability endpoints

  • Direct secure messaging: keith.paige@direct.vmmc.org
  • Direct secure messaging: kpaige22962@direct.tecmc.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1336152180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 EVERGREEN WAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982036421",
            "telephone_number": "206-860-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1229 MADISON ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981043586",
            "telephone_number": "206-860-4686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAIGE",
        "first_name": "KEITH",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "WA",
            "license": "MD00036238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRY",
            "identifier": "0039572",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALASKA MEDICAID",
            "identifier": "MD8236",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA/USHC SPECIALIST",
            "identifier": "US1037407",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "240007287",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8229619",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "PA0297",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.