Individual provider Active NPI

Jason Tsun-Yin Poon, M.D.

  • Neurology Physician
  • Kirkland, WA
National Provider Identifier
1417319658
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MD.MD.61170738 Issued in WA
Practice address
12039 NE 128TH St Ste 300
Kirkland, WA 98034-3029
Phone
(425) 899-3135
Fax
(425) 899-3143
NPI assigned
Mar 27, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 10493618-1205 UT
Student in an Organized Health Care Education/Training Program 390200000X
Neurology Physician 2084N0400X MD.MD.61170738 WA Primary

Addresses

Primary practice location

12039 NE 128TH St Ste 300
Kirkland, WA 98034-3029

Mailing address

12039 NE 128TH St Ste 300
Kirkland, WA 98034-3029
Phone (425) 899-3135

Other practice location 1

175 N Medical Dr E
Salt Lake City, UT 84132-0001
Phone (801) 585-6387 ext. 80158

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
I20210625001088 WA Practitioner - Neurology 9638435043 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Rochester School of Medicine and Dentistry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
King County Public Hospital District No 2Group PAC ID 7618880097, 586 clinicians

Practice addresses (Care Compare)

12039 NE 128TH St
Suite 300
Kirkland, WA 98034-3029
Phone (425) 899-5350

Hospital & facility affiliations

  • Evergreenhealth Medical Center Hospital, Kirkland, WA, CCN 500124
  • Evergreenhealth Monroe Hospital, Monroe, WA, CCN 500084

Merit-based Incentive Payment System (MIPS)

Final score
86.73 of 100Reported as apm
Quality
73.46
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10493618-1205UTMDNeurology Physician
MD.MD.61170738WAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No 2 Current Accepting new patients
Overlake Medical Clinics LLC CurrentSince Mar 1, 2024 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
Overlake Medical Clinics, LLC CurrentSince Mar 1, 2024 Accepting new patients
King County Public Hospital District No. 2 CurrentSince Aug 1, 2021 Accepting new patients
King County Public Hospital District No 2 CurrentSince Aug 1, 2021 Accepting new patients

Locations

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

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

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

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

12039 NE 128th St
Ste 300
Kirkland, WA 98034
Phone (425) 899-3123

14701 179th Ave SE
Ste 2
Monroe, WA 98272

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1459036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1417319658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12039 NE 128TH ST STE 300",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343029",
            "telephone_number": "425-899-3135",
            "fax_number": "425-899-3143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12039 NE 128TH ST STE 300",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343029",
            "telephone_number": "425-899-3135",
            "fax_number": "425-899-3143"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "175 N Medical Dr E",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841320001",
            "country_code": "US",
            "telephone_number": "801-585-6387 x80158",
            "fax_number": "801-581-4192",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POON",
        "first_name": "JASON",
        "middle_name": "TSUN-YIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-27",
        "last_updated": "2021-09-16",
        "certification_date": "2021-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "UT",
            "license": "10493618-1205",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WA",
            "license": "MD.MD.61170738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.