Individual provider Active NPI

Gaetan S Habekoss, MD

  • Family Medicine Physician
  • Seattle, WA
National Provider Identifier
1437319191
Registry record updated Aug 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60824901 Issued in WA
Practice address
4915 25TH Ave NE Ste 300W
Seattle, WA 98105
Phone
(206) 520-5000
NPI assigned
Jun 16, 2008
Last updated
Aug 24, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD60824901 WA Primary

Addresses

Primary practice location

4915 25TH Ave NE Ste 300W
Seattle, WA 98105

Mailing address

PO Box 50095
Seattle, WA 98145-5095
Phone (206) 520-5700

Other identifiers 2

IdentifierTypeStateIssuer
P01059336OtherCARAILROAD MEDICARE
1437319191MedicaidCA

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
I20181009002404 WA Practitioner - Family Practice 5294915013 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Association of University PhysiciansGroup PAC ID 0446162697, 3,484 clinicians

Practice addresses (Care Compare)

4915 25TH Ave NE 300
Uwnc Ravenna Clinic
Seattle, WA 98105-5668
Phone (206) 525-7777

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
105671CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
The Association of University Physicians Family Medicine CurrentSince Aug 24, 2018 Accepting new patients

Locations

4915 25th Ave NE
Ste 300W
Seattle, WA 98105
Phone (206) 520-1606

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

4915 25th Ave NE
Ste 300
Seattle, WA 98105
Phone (206) 525-7777

Interoperability endpoints

  • Direct secure messaging: ghabekoss761621@direct.ehre.uwmedicine.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535068800000",
    "number": "1437319191",
    "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",
            "telephone_number": "206-520-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4915 25TH AVE NE STE 300W",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98105",
            "telephone_number": "206-520-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HABEKOSS",
        "first_name": "GAETAN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-16",
        "last_updated": "2018-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60824901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01059336",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1437319191",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.