Individual provider Active NPI

Kevin Lee Coleman

  • Physician Assistant
  • Seattle, WA
National Provider Identifier
1396825352
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10004084 Issued in WA
Practice address
Ambulatory Clinic
825 Eastlake Avenue East
Seattle, WA 98109
Phone
(206) 288-1000
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10004084 WA Primary

Addresses

Primary practice location

Ambulatory Clinic
825 Eastlake Avenue East
Seattle, WA 98109

Mailing address

PO Box 50095
Seattle, WA 98145-5095

Other identifiers 2

IdentifierTypeStateIssuer
8382137MedicaidWA
312530OtherINTERNAL ID-MOTOR VEHICLE ID

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
I20031209000185 WA Practitioner - Physician Assistant 0840196143 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Association of University PhysiciansGroup PAC ID 0446162697, 3,484 clinicians

Practice addresses (Care Compare)

1701 Columbia Rd
Seattle, WA 98195-0001
Phone (206) 598-3100

1959 NE Pacific St
Seattle, WA 98195-0001
Phone (206) 598-4333

Hospital & facility affiliations

  • University of Washington Medical Ctr Hospital, Seattle, WA, CCN 500008

Merit-based Incentive Payment System (MIPS)

Final score
93.85 of 100Reported as apm
Quality
74.6
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1428COMDOccupational Therapist
PA10004084WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Cardiac Surgery PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kcoleman80397@direct.ehre.uwmedicine.org

Organizations & group practices 2

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396825352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AMBULATORY CLINIC",
            "address_2": "825 EASTLAKE AVENUE EAST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98109",
            "telephone_number": "206-288-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "KEVIN",
        "middle_name": "LEE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10004084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8382137",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERNAL ID-MOTOR VEHICLE ID",
            "identifier": "312530",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.