Organization Active NPI

Sleep Diagnostics NW PLLC

  • Pulmonary Disease Physician
  • Arlington, WA
National Provider Identifier
1376308106
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
SLEEP DIAGNOSTICS NW PLLC
Practice address
16410 Smokey Point Blvd Ste 106
Arlington, WA 98223-7079
Phone
(619) 405-3219
NPI assigned
Feb 20, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Authorized official

Name
Jemma Bockenkamp
Title
Manager
Phone
(360) 631-4437

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X Primary
Sleep Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RS0012X

Addresses

Primary practice location

16410 Smokey Point Blvd Ste 106
Arlington, WA 98223-7079

Mailing address

16410 Smokey Point Blvd Ste 106
Arlington, WA 98223-7079

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20240408001732 WA Part B Supplier - Clinic/Group Practice 7113365321 Receives reassigned benefits from 1 practitioner
Practice locations: Arlington, WA
O20260112001961 CA Part B Supplier - Clinic/Group Practice 7113365321 Receives reassigned benefits from 1 practitioner
Practice locations: San Diego, CA

National Provider Directory

National Provider Directory

Locations

16410 Smokey Point Blvd
Ste 106
Arlington, WA 98223
Phone (360) 547-7586

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1708387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708387200000",
    "number": "1376308106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16410 SMOKEY POINT BLVD STE 106",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982237079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16410 SMOKEY POINT BLVD STE 106",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982237079",
            "telephone_number": "619-405-3219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLEEP DIAGNOSTICS NW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-20",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A",
        "authorized_official_last_name": "BOCKENKAMP",
        "authorized_official_first_name": "JEMMA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "360-631-4437"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; 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.