Individual provider Active NPI

Camille Melinda Clinton, MD

  • Orthopaedic Surgery Physician
  • Kirkland, WA
National Provider Identifier
1356509475
Registry record updated Nov 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD60010627 Issued in WA
Practice address
12911 120TH Ave NE
Suite H-210
Kirkland, WA 98034-3027
Phone
(425) 823-4000
Fax
(425) 821-3550
NPI assigned
May 27, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 244646 NY
Orthopaedic Surgery Physician 207X00000X MD60010627 WA Primary

Addresses

Primary practice location

12911 120TH Ave NE
Suite H-210
Kirkland, WA 98034-3027

Mailing address

805 Madison Street
Suite 901
Seattle, WA 98104-1172
Phone (206) 264-8100

Other identifiers 5

IdentifierTypeStateIssuer
G8875987OtherWAMEDICARE EOC
8532848MedicaidWA
0240111OtherWALNI
G8876689OtherWAMEDICARE EASTSIDE MRI
P00629119OtherWAMEDICARE RR KING CO.

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
I20081007000012 WA Practitioner - Orthopedic Surgery 6103994967 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Georgetown University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

12039 NE 128TH St
Suite 400
Kirkland, WA 98034-3029
Phone (425) 899-1210

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement43
Lower limb (leg) arthroscopy (minimally invasive joint repair)15
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60010627WAMDOrthopaedic Surgery Physician
244646NYMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc P S Orthopaedic Surgery Current Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
King County Public Hospital District No 2 CurrentSince Feb 1, 2023 Accepting new patients
King County Public Hospital District No. 2 CurrentSince Feb 1, 2023 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
Proliance Surgeons, Inc., P.S. CurrentSince Sep 1, 2008 Accepting new patients
Proliance Surgeons Inc P S Orthopaedic Surgery CurrentSince Sep 1, 2008 Accepting new patients

Locations

1909 214th St SE
Ste 110
Bothell, WA 98021
Phone (425) 488-4988

510 8th Ave NE
Ste 110
Issaquah, WA 98029
Phone (425) 507-0810

510 8th Ave NE
Ste 200
Issaquah, WA 98029
Phone (425) 392-3030

12039 NE 128th St
Ste 400
Kirkland, WA 98034
Phone (425) 899-4810

12911 120th Ave NE
Ste H210
Kirkland, WA 98034
Phone (425) 823-4000

12911 120th Ave NE
Ste H120
Kirkland, WA 98034
Phone (425) 823-4226

12039 NE 128th St
Ste 300
Kirkland, WA 98034
Phone (425) 899-3123

12911 120th Ave NE
Ste G10
Kirkland, WA 98034
Phone (425) 481-6301

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

Organizations & group practices 7

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 3

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": "1211846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352937600000",
    "number": "1356509475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 MADISON STREET",
            "address_2": "SUITE 901",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041172",
            "telephone_number": "206-264-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12911 120TH AVE NE",
            "address_2": "SUITE H-210",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343027",
            "telephone_number": "425-823-4000",
            "fax_number": "425-821-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLINTON",
        "first_name": "CAMILLE",
        "middle_name": "MELINDA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-27",
        "last_updated": "2012-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NY",
            "license": "244646",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WA",
            "license": "MD60010627",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE EOC",
            "identifier": "G8875987",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8532848",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LNI",
            "identifier": "0240111",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE EASTSIDE MRI",
            "identifier": "G8876689",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR KING CO.",
            "identifier": "P00629119",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.