Individual provider Active NPI

Zackary Gainer

  • Surgical Physician Assistant
  • Kirkland, WA
National Provider Identifier
1396563607
Registry record updated Jan 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA61639442 Issued in WA
Practice address
12039 NE 128TH St Ste 500
Kirkland, WA 98034-3029
Phone
(425) 899-4930
NPI assigned
Sep 26, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA61639442 WA Primary
Physician Assistant 363A00000X PA61639442 WA

Addresses

Primary practice location

12039 NE 128TH St Ste 500
Kirkland, WA 98034-3029

Mailing address

12039 NE 128TH St Ste 500
Kirkland, WA 98034-3029
Phone (425) 899-4930

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241228000001 WA Practitioner - Physician Assistant 0840727061 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
King County Public Hospital District No 2Group PAC ID 7618880097, 586 clinicians

Practice addresses (Care Compare)

12033 NE 130TH LN
Suite 120
Kirkland, WA 98034-3052
Phone (425) 899-2160

12039 NE 128TH St
Kirkland, WA 98034-3029

12040 NE 128TH St
Kirkland, WA 98034-3013

12040 NE 128TH St Ms
Suite 55
Kirkland, WA 98034-3013

Hospital & facility affiliations

  • Evergreenhealth Medical Center Hospital, Kirkland, WA, CCN 500124

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA61639442WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No. 2 CurrentSince Dec 1, 2024 Accepting new patients
King County Public Hospital District No 2 CurrentSince Dec 1, 2024 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
Overlake Medical Clinics, LLC Past Accepting new patients

Locations

1135 116th Ave NE
Ste 500
Bellevue, WA 98004
Phone (425) 454-3938

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

1909 214th St SE
Ste 110
Bothell, WA 98021
Phone (425) 488-4988

12039 NE 128th St
Ste 500
Kirkland, WA 98034
Phone (425) 899-1220

12040 NE 128th St
Kirkland, WA 98034
Phone (425) 899-1000

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1727308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736380800000",
    "number": "1396563607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12039 NE 128TH ST STE 500",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343029",
            "telephone_number": "425-899-4930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12039 NE 128TH ST STE 500",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343029",
            "telephone_number": "425-899-4930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAINER",
        "first_name": "ZACKARY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-26",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA61639442",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61639442",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.