Individual provider Active NPI

Alexandra Zaballa, MD

  • Family Medicine Physician
  • Burien, WA
National Provider Identifier
1437511185
Registry record updated Aug 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60852620 Issued in WA
Practice address
14434 Ambaum Blvd SW Ste 5
Burien, WA 98166-1438
Phone
(206) 812-6140
Fax
(206) 812-2466
NPI assigned
Mar 22, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD60852620 WA
Family Medicine Physician 207Q00000X MD60852620 WA Primary

Addresses

Primary practice location

14434 Ambaum Blvd SW Ste 5
Burien, WA 98166-1438

Mailing address

PO Box 34703
Seattle, WA 98124-1703

Other practice location 1

550 16th Ave
#100
Seattle, WA 98122-5699
Phone (206) 762-3730

Other identifiers 1

IdentifierTypeStateIssuer
2065199MedicaidWA

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
I20190913000163 WA Practitioner - Family Practice 4880947787 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Washington School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sea Mar Community Health CentersGroup PAC ID 7315831161, 235 clinicians

Practice addresses (Care Compare)

14434 Ambaum Blvd SW
Suite 5
Burien, WA 98166-1438
Phone (206) 812-6140

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60852620WAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sea Mar Community Health Centers Family Medicine Current Accepting new patients
Sea Mar Community Health Centers CurrentSince Aug 15, 2019 Accepting new patients
Sea Mar Community Health Centers Family Medicine CurrentSince Aug 15, 2019 Accepting new patients
Sea-Mar Community Health Center Family Medicine Past Accepting new patients
Swedish Health Services Past Accepting new patients

Locations

14434 Ambaum Blvd SW
Ste 5
Burien, WA 98166
Phone (206) 244-9482

8720 14th Ave S
Seattle, WA 98108
Phone (206) 762-3730

Interoperability endpoints

  • Direct secure messaging: azaballa450981@direct.multicare.org

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722902400000",
    "number": "1437511185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34703",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14434 AMBAUM BLVD SW STE 5",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981661438",
            "telephone_number": "206-812-6140",
            "fax_number": "206-812-2466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 16th Ave",
            "address_2": "#100",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981225699",
            "country_code": "US",
            "telephone_number": "206-762-3730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZABALLA",
        "first_name": "ALEXANDRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-22",
        "last_updated": "2024-08-06",
        "certification_date": "2024-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "MD60852620",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60852620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2065199",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burien, WA

Sources for this page

Verify at the official NPI Registry.