Kelly Anne Griffith-Bauer, M.D.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

MD60847731 Issued in WA

Practice address

509 Olive Way Ste 200&900
Seattle, WA 98101-1720

Phone

(206) 860-5571

Fax

(206) 860-2219

NPI assigned

May 30, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Dermatology

Education

Oregon Health Sciences University School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology Clinic PLLCGroup PAC ID 2860626207, 3 clinicians

Epiphany Dermatology of Washington PLLCGroup PAC ID 8224560776, 7 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Dermatology Clinic PLLC

  • Specialist
  • Mercer Island, WA
  • NPI 1134467962
  Medicare reassignment Care Compare group NPD
• Epiphany Dermatology of Washington PLLC

  • Dermatology Physician
  • Mercer Island, WA
  • NPI 1053142778
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1338336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1386905917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 OLIVE WAY STE 200&900",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011720",
            "telephone_number": "206-860-5571",
            "fax_number": "206-860-2219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 OLIVE WAY STE 200&900",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981011720",
            "telephone_number": "206-860-5571",
            "fax_number": "206-860-2219"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3550 N Interstate Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972271196",
            "country_code": "US",
            "telephone_number": "503-813-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIFFITH-BAUER",
        "first_name": "KELLY",
        "middle_name": "ANNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-30",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "PG158620",
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "WA",
            "license": "MD60847731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Ward Griffin
• Whitney Griffin
• Yvonne Griffin, CNM
• Madison K Griffis, MSW, LSWAIC
• Marianne Griffith Matney, LMT
• Denise Lonetta Griffith, DPT
• Julia Pham Griffith, ARNP
• Max Griffith, MD
• Jennifer B Griffiths, MD
• Richard Craig Griffiths, M.D.

• MOHS-Micrographic Surgery Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• MOHS-Micrographic Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.