Individual provider Active NPI

Kimberley Chiu, MD

  • Obstetrics & Gynecology Physician
  • Renton, WA
National Provider Identifier
1356795561
Registry record updated Nov 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD61407539 Issued in WA
Practice address
4033 Talbot Rd S Ste 430
Renton, WA 98055-5700
Phone
(425) 690-3474
Fax
(425) 690-9055
NPI assigned
Apr 14, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 2020006663 MO
Obstetrics & Gynecology Physician 207V00000X MD61407539 WA Primary

Addresses

Primary practice location

4033 Talbot Rd S Ste 430
Renton, WA 98055-5700

Mailing address

4033 Talbot Rd S Ste 430
Renton, WA 98055-5700
Phone (425) 690-3474

Other practice location 1

4901 Forest Park Ave
Div OBGYN Pelvic Med/Reconstruct Surg, Ste 710
Saint Louis, MO 63108-1495
Phone (314) 747-1402

Other identifiers 1

IdentifierTypeStateIssuer
200085382MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

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
I20230920003136 WA Practitioner - Obstetrics/Gynecology 6103164785 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Albert Einstein College of Medicine of Yeshiva University, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valley Medical Group-RentonGroup PAC ID 4183753965, 419 clinicians

Practice addresses (Care Compare)

4033 Talbot Rd S
Suite 430
Renton, WA 98055-5700
Phone (425) 656-4110

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions11
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2020006663MOMDObstetrics & Gynecology Physician
MD61407539WAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of the Northwest Obstetrics & Gynecology CurrentSince Sep 11, 2023 Accepting new patients
Valley Medical Group-Renton CurrentSince Nov 1, 2023 Accepting new patients
Kaiser Foundation Health Plan of the Northwest Obstetrics & Gynecology Current Accepting new patients
Public Hospital District #1 of King County Past Accepting new patients

Locations

10100 SE Sunnyside Rd
Clackamas, OR 97015
Phone (503) 571-2946

7201 N Interstate Ave
Portland, OR 97217
Phone (503) 240-4051

2400 Lancaster Dr NE
Salem, OR 97305
Phone (503) 361-5400

16850 SE 272nd St
Ste 100
Covington, WA 98042
Phone (253) 395-1971

1230 7th Ave
Longview, WA 98632
Phone (360) 575-4801

3600 Lind Ave SW
Ste 100
Renton, WA 98057

4033 Talbot Rd S
Ste 430
Renton, WA 98055
Phone (425) 227-0231

7101 NE 137th Ave
Vancouver, WA 98682
Phone (360) 418-6000

Interoperability endpoints

  • Direct secure messaging: kchiu1260933@direct.carenet.org
  • Direct secure messaging: kchiu116529@direct.valleymed.org

Organizations & group practices 4

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 2

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": "1460592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699660800000",
    "number": "1356795561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4033 TALBOT RD S STE 430",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555700",
            "telephone_number": "425-690-3474",
            "fax_number": "425-690-9055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4033 TALBOT RD S STE 430",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555700",
            "telephone_number": "425-690-3474",
            "fax_number": "425-690-9055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4901 Forest Park Ave",
            "address_2": "Div OBGYN Pelvic Med/Reconstruct Surg, Ste 710",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631081495",
            "country_code": "US",
            "telephone_number": "314-747-1402",
            "fax_number": "314-362-3328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHIU",
        "first_name": "KIMBERLEY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-14",
        "last_updated": "2023-11-11",
        "certification_date": "2023-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MO",
            "license": "2020006663",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "MD61407539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200085382",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "4901 Forest Park Ave",
            "address_2": "Div OBGYN Pelvic Med/Reconstruct Surg, Ste 710",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631081495",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.