Individual provider Active NPI

Patricia Egwuatu

  • Family Medicine Physician
  • Seattle, WA
National Provider Identifier
1366803108
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OL60743333 Issued in WA
Practice address
201 16TH Ave E
Seattle, WA 98112-5226
Phone
(206) 326-3000
NPI assigned
Mar 7, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OL60743333 WA Primary

Addresses

Primary practice location

201 16TH Ave E
Seattle, WA 98112-5226

Mailing address

33111 135TH PL SE
Auburn, WA 98092-8514

Other practice location 1

7600 River Rd
North Bergen, NJ 07047-6217
Phone (201) 710-2755

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync Health Information Exchange (HIE)

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
I20191008003296 WA Practitioner - Family Practice 3173854031 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

125 16TH Ave E
Seattle, WA 98112-5211
Phone (206) 326-2662

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OL60743333WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince Aug 10, 2019 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Aug 10, 2019 Accepting new patients

Locations

125 16th Ave E
Seattle, WA 98112
Phone (206) 326-3530

201 16th Ave E
Seattle, WA 98112
Phone (206) 326-4545

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: pegwuatu232280@ghc.direct-ci.net

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": "1457308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1366803108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33111 135TH PL SE",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980928514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 16TH AVE E",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981125226",
            "telephone_number": "206-326-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7600 River Rd",
            "address_purpose": "LOCATION",
            "city": "North Bergen",
            "state": "NJ",
            "postal_code": "070476217",
            "country_code": "US",
            "telephone_number": "201-710-2755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EGWUATU",
        "first_name": "PATRICIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-07",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OL60743333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "201 16th Ave E",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981125226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.