NPIMap

Organization Active NPI

Neurotech, LLC

  • EEG Specialist/Technologist
  • Kent, WA
National Provider Identifier
1356776322
Registry record updated Mar 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
EEG Specialist/TechnologistTaxonomy code 246ZE0500X
Legal business name
NEUROTECH, LLC
Practice address
6627 S 191St PL Ste F110
Kent, WA 98032-2118
Phone
(866) 374-7648
NPI assigned
Sep 10, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2025

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

Authorized official

Name
Christopher Blank
Title
Contracting & Credentialing Manager
Phone
(262) 875-6575

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
EEG Specialist/TechnologistGroup: 193400000X SINGLE SPECIALTY GROUP 246ZE0500X Primary
Sleep Disorder Diagnostic Clinic/Center 261QS1200X
Physiological Laboratory 293D00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 335V00000X

Addresses

Primary practice location

6627 S 191St PL Ste F110
Kent, WA 98032-2118

Mailing address

626 W Moreland Blvd
Waukesha, WI 53188-2433
Phone (262) 754-0898

Other identifiers 1

IdentifierTypeStateIssuer
1356776322MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231211000885 WA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 6305948225 Practice locations: Tacoma, WA

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Neurotech LLC20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

Locations

11200 Kirkland Way
Ste 375
Kirkland, WA 98033

NPI Registry JSON

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

{
    "created_epoch": "1378771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741737600000",
    "number": "1356776322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 W MORELAND BLVD",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531882433",
            "telephone_number": "262-754-0898",
            "fax_number": "262-754-0897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6627 S 191ST PL STE F110",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980322118",
            "telephone_number": "866-374-7648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROTECH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-10",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A",
        "authorized_official_last_name": "BLANK",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CONTRACTING & CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "262-875-6575"
    },
    "taxonomies": [
        {
            "code": "246ZE0500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other, EEG",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1356776322",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.