Individual provider Active NPI

Sandra Perlmutter, ARNP

  • Nurse Practitioner
  • Seattle, WA
National Provider Identifier
1447227921
Registry record updated Jun 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP30006307 Issued in WA
Practice address
904 7TH Ave FL 7
Suite 400
Seattle, WA 98104-1132
Phone
(206) 860-2302
NPI assigned
Mar 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP30006307 WA Primary

Addresses

Primary practice location

904 7TH Ave FL 7
Suite 400
Seattle, WA 98104-1132

Mailing address

550 17TH Ave
Suite 400
Seattle, WA 98122-5788
Phone (206) 860-2302

Other identifiers 1

IdentifierTypeStateIssuer
9635012MedicaidWA

Other names 1

  • Sandra Johnson Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070811000148 WA Practitioner - Nurse Practitioner 7416048921 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP30006307WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No. 2 CurrentSince Nov 4, 2015 Accepting new patients
Overlake Medical Clinics, LLC CurrentSince Jan 18, 2015 Accepting new patients
Overlake Medical Clinics LLC CurrentSince Jan 18, 2015 Accepting new patients
King County Public Hospital District No 2 CurrentSince Nov 4, 2015 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients

Locations

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

12303 NE 130th Ln
Ste 225
Kirkland, WA 98034
Phone (425) 899-3890

12040 NE 128th St
#10
Kirkland, WA 98034
Phone (206) 466-0369

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

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403827200000",
    "number": "1447227921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 17TH AVE",
            "address_2": "SUITE 400",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225788",
            "telephone_number": "206-860-2302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 7TH AVE FL 7",
            "address_2": "SUITE 400",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041132",
            "telephone_number": "206-860-2302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERLMUTTER",
        "first_name": "SANDRA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-03",
        "last_updated": "2014-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30006307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9635012",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "JOHNSON",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.