Individual provider Active NPI

Koki Kobata, D.C.

  • Chiropractor
  • Bellevue, WA
National Provider Identifier
1366590754
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH00003604 Issued in WA
Practice address
15100 SE 38TH St
Suite 305-B
Bellevue, WA 98006-1728
Phone
(425) 289-0092
Fax
(425) 289-0095
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
Yes

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
Chiropractor 111N00000X CH00003604 WA Primary

Addresses

Primary practice location

15100 SE 38TH St
Suite 305-B
Bellevue, WA 98006-1728

Mailing address

15100 SE 38TH St
Ste 305B
Bellevue, WA 98006-1728
Phone (425) 289-0092

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040330000254 WA Practitioner - Chiropractic 4486544327 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

14700 NE 8TH St
Suite 115
Bellevue, WA 98007-4115
Phone (425) 644-8386

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wellnessone of Eastgate, PS PastSince Aug 7, 2014 Accepting new patients

Organizations & group practices 2

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366590754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15100 SE 38TH ST",
            "address_2": "STE 305B",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980061728",
            "telephone_number": "425-289-0092",
            "fax_number": "425-289-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15100 SE 38TH ST",
            "address_2": "SUITE 305-B",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980061728",
            "telephone_number": "425-289-0092",
            "fax_number": "425-289-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBATA",
        "first_name": "KOKI",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00003604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, 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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.