NPIMap

Organization Active NPI

Advanced Family Medicine

  • Podiatrist
  • Bellevue, WA
National Provider Identifier
1376763433
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO00000798 Issued in WA
Legal business name
ADVANCED FAMILY MEDICINE
Practice address
1940 116TH Ave NE
Suite 200
Bellevue, WA 98004-3097
Phone
(425) 453-6838
Fax
(425) 456-0106
NPI assigned
Apr 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Irine Vaiman, M.D.
Title
Medical Director
Phone
(425) 453-6838

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X PO00000798 WA Primary

Addresses

Primary practice location

1940 116TH Ave NE
Suite 200
Bellevue, WA 98004-3097

Mailing address

1940 116TH Ave NE
Suite 200
Bellevue, WA 98004-3097
Phone (425) 453-6838

Other identifiers 1

IdentifierTypeStateIssuer
7122799MedicaidWA

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FBJCBA

NPI Registry JSON

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

{
    "created_epoch": "1177891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376763433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 116TH AVE NE",
            "address_2": "SUITE 200",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043097",
            "telephone_number": "425-453-6838",
            "fax_number": "425-456-0106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 116TH AVE NE",
            "address_2": "SUITE 200",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043097",
            "telephone_number": "425-453-6838",
            "fax_number": "425-456-0106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VAIMAN",
        "authorized_official_first_name": "IRINE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "425-453-6838",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "WA",
            "license": "PO00000798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7122799",
            "state": "WA"
        }
    ],
    "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 Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.