NPIMap

Individual provider Active NPI

Nancy Corbett, PA

  • Surgical Physician Assistant
  • Kirkland, WA
National Provider Identifier
1356420475
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA10003334 Issued in WA
Practice address
12303 NE 130TH LN
Suite 520
Kirkland, WA 98034-3099
Phone
(425) 899-5510
Fax
(425) 899-5524
NPI assigned
Nov 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA10003334 WA Primary

Addresses

Primary practice location

12303 NE 130TH LN
Suite 520
Kirkland, WA 98034-3099

Mailing address

PO Box 8592
Kirkland, WA 98034-0592
Phone (425) 899-5510

Other identifiers 3

IdentifierTypeStateIssuer
6622COOtherWAREGENCE
0172759OtherWALABOR AND INDUSTRIES
P00186955OtherWARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
PA Surgical Services Surgical Past Accepting new patients
Eastside Vascular LLP Past Accepting new patients
Associated Emergency Room Physicians, Inc P.S. PastSince Jan 10, 2021 Accepting new patients
Stanley a. Kopp, M.D., P.S. Past Accepting new patients
Bruce a Rolfe, MD Past Accepting new patients
Overlake Medical Clinics, LLC Past Accepting new patients
Public Hospital District 1 of King County Past Accepting new patients
Institute for Laparoscopic Surgery PLLC Past Accepting new patients
Pacific Gynecology Specialists, PC Past Accepting new patients
Pacific Gynecology Specialists, PC Past Accepting new patients

Organizations & group practices 10

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356420475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8592",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980340592",
            "telephone_number": "425-899-5510",
            "fax_number": "425-899-5524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12303 NE 130TH LN",
            "address_2": "SUITE 520",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343099",
            "telephone_number": "425-899-5510",
            "fax_number": "425-899-5524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORBETT",
        "first_name": "NANCY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA10003334",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "6622CO",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0172759",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00186955",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.