NPIMap

Organization Active NPI

Pediatric Associates, Inc., P.S. Dba Allegro Pediatrics

Doing business as Redmond Ridge

  • Pediatrics Physician
  • Redmond, WA
National Provider Identifier
1396819975
Registry record updated Oct 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATRIC ASSOCIATES, INC., P.S. DBA ALLEGRO PEDIATRICS
Doing business as
Redmond Ridge
Practice address
22635 Market Place Drive
Suite #120
Redmond, WA 98053
Phone
(425) 898-7408
NPI assigned
Nov 17, 2006
Last updated
Oct 9, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2020

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

Authorized official

Name
Brett Vandenberg
Title
Ceo
Phone
(425) 460-5643

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

22635 Market Place Drive
Suite #120
Redmond, WA 98053

Mailing address

2475 140TH Ave. NE, Building C
Bellevue, WA 98005
Phone (425) 460-5601

Other names 1

  • Redmond Ridge Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Associates Inc PS Dba Allegro Pediatrics9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602201600000",
    "number": "1396819975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2475 140TH AVE. NE, BUILDING C",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98005",
            "telephone_number": "425-460-5601",
            "fax_number": "425-460-5606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22635 MARKET PLACE DRIVE",
            "address_2": "SUITE #120",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "98053",
            "telephone_number": "425-898-7408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ASSOCIATES, INC., P.S. DBA ALLEGRO PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A",
        "authorized_official_last_name": "VANDENBERG",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "425-460-5643"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Redmond Ridge",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Redmond Ridge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Redmond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.