NPIMap

Anastasia Bakulina, MD

Individual provider Active NPI Internal Medicine Physician · Everett, WA

NPI 1407464993 · NPPES record last updated Jul 13, 2023

Key facts

NPI
1407464993
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
MD.MD.61409813 (WA)
Practice address
1424 Broadway
Everett, WA 98201
Phone
(425) 789-2000
Fax
(425) 789-2096
NPI assigned
Jul 21, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 19

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 3

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

Medicare Care Compare profile

Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Center of Snohomish County (84 clinicians)
Select Outpatient Services Inc (750 clinicians)
Select Rehabilitation, LLC (1,935 clinicians)

Practice addresses (Care Compare)

1019 112TH St SW
Everett, WA 98204-4875
Phone (425) 551-6200

1424 Broadway
Everett, WA 98201-1720
Phone (425) 789-2000

2600 Compass Rd
Glenview, IL 60026-8001

Hospital & facility affiliations

  • Providence at Home With Compassus, Snohomish County Home health agency · Everett, WA · CCN 507065
  • Providence Regional Medical Center Everett Hospital · Everett, WA · CCN 500014

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20231107003450 WA Practitioner - Internal Medicine 5496166472 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.MD.61409813WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center of Snohomish County Current
since Oct 2, 2023		 Accepting new patients
Community Health Center of Snohomish County Current
since Oct 2, 2023		 Accepting new patients

Locations

326 S Stillaguamish Ave
Arlington, WA 98223
Phone (360) 435-2144

23320 Highway 99
Edmonds, WA 98026
Phone (425) 640-5500

1019 112th St SW
Everett, WA 98204
Phone (425) 551-6001

8609 Evergreen Way
Everett, WA 98208
Phone (425) 551-6200

930 N Broadway
Everett, WA 98201
Phone (425) 317-0300

4201 Rucker Ave
Everett, WA 98203
Phone (425) 382-4000

1424 Broadway
Everett, WA 98201
Phone (425) 551-1000

4111 194th St SW
Lynnwood, WA 98036
Phone (425) 835-5200

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD.MD.61409813 WA Yes

Addresses

Primary practice location

1424 Broadway
Everett, WA 98201

Mailing address

1424 Broadway
Everett, WA 98201-1720
Phone (425) 789-2000

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 13, 2023.

{
    "created_epoch": "1595289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1407464993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1424 BROADWAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011720",
            "telephone_number": "425-789-2000",
            "fax_number": "425-789-2096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 BROADWAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "98201",
            "telephone_number": "425-789-2000",
            "fax_number": "425-789-2096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKULINA",
        "first_name": "ANASTASIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-21",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD.MD.61409813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

All providers in Everett, WA · Internal Medicine Physician in Washington

Sources for this page

Verify at the official NPI Registry.