Individual provider Active NPI

Yoshihiro Yamamoto, M.D.

  • Neurological Surgery Physician
  • Olympia, WA
National Provider Identifier
1396775896
Registry record updated Apr 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
MD00045465 Issued in WA
Practice address
615 Lilly Rd NE
Ste. 100
Olympia, WA 98506-5117
Phone
(360) 491-4211
Fax
(360) 493-0407
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X MD00045465 WA Primary

Addresses

Primary practice location

615 Lilly Rd NE
Ste. 100
Olympia, WA 98506-5117

Mailing address

PO Box 368
Olympia, WA 98507-0368
Phone (360) 491-4211

Other identifiers 1

IdentifierTypeStateIssuer
8437014MedicaidWA

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
I20051102001125 WA Practitioner - Neurosurgery 1557389111 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00045465WAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Overlake Medical Clinics, LLC CurrentSince Jun 1, 2022 Accepting new patients
Overlake Medical Clinics LLC CurrentSince Jun 1, 2022 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
King County Public Hospital District No. 2 CurrentSince Jun 1, 2022 Accepting new patients
King County Public Hospital District No 2 CurrentSince Jun 1, 2022 Accepting new patients

Locations

1750 112th Ave NE
Ste B102
Bellevue, WA 98004
Phone (425) 688-5460

12040 NE 128th St
#50
Kirkland, WA 98034
Phone (425) 899-1894

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366156800000",
    "number": "1396775896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 368",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985070368",
            "telephone_number": "360-491-4211",
            "fax_number": "360-493-0407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 LILLY RD NE",
            "address_2": "STE. 100",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065117",
            "telephone_number": "360-491-4211",
            "fax_number": "360-493-0407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAMAMOTO",
        "first_name": "YOSHIHIRO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2013-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "WA",
            "license": "MD00045465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8437014",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.