Individual provider Active NPI

Jennifer L Heydt, MD

  • Otolaryngology Physician
  • Bellevue, WA
National Provider Identifier
1437151081
Registry record updated Oct 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD00042735 Issued in WA
Practice address
1800 116TH Ave NE
Suite 102
Bellevue, WA 98004-3043
Phone
(425) 451-3710
Fax
(425) 451-2636
NPI assigned
Aug 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD00042735 WA Primary

Addresses

Primary practice location

1800 116TH Ave NE
Suite 102
Bellevue, WA 98004-3043

Mailing address

805 Madison St
Suite 901
Seattle, WA 98104-1172
Phone (206) 264-8100

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
I20040122000169 WA Practitioner - Otolaryngology 3678475571 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of California, San Diego School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

12303 NE 130TH LN
Suite 400
Kirkland, WA 98034-3041
Phone (425) 899-4592

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No 2 CurrentSince Aug 1, 2018 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
Proliance Surgeons, Inc., P.S. CurrentSince Jul 1, 2007 Accepting new patients
Proliance Surgeons Inc P S CurrentSince Jul 1, 2007 Accepting new patients
King County Public Hospital District No. 2 CurrentSince Aug 1, 2018 Accepting new patients
Proliance Surgeons Inc P S Current Accepting new patients

Locations

1800 116th Ave NE
Ste 102
Bellevue, WA 98004
Phone (425) 451-3710

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

12303 NE 130th Ln
Ste 230
Kirkland, WA 98034
Phone (425) 899-3888

12303 NE 130th Ln
Ste 400
Kirkland, WA 98034
Phone (425) 450-7007

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

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": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319414400000",
    "number": "1437151081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 MADISON ST",
            "address_2": "SUITE 901",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041172",
            "telephone_number": "206-264-8100",
            "fax_number": "206-264-8689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 116TH AVE NE",
            "address_2": "SUITE 102",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043043",
            "telephone_number": "425-451-3710",
            "fax_number": "425-451-2636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEYDT",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-12",
        "last_updated": "2011-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WA",
            "license": "MD00042735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.