Individual provider Active NPI

Kellan James Kading, M.D.

  • Surgery Physician
  • Seattle, WA
National Provider Identifier
1447517735
Registry record updated Aug 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ML60293216 Issued in WA
Practice address
747 Broadway
Suite WW-739
Seattle, WA 98122-4379
Phone
(206) 386-6721
NPI assigned
Apr 12, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X ML60293216 WA Primary

Addresses

Primary practice location

747 Broadway
Suite WW-739
Seattle, WA 98122-4379

Mailing address

747 Broadway
Suite WW-739
Seattle, WA 98122-4379
Phone (206) 386-6721

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20170831002032 ID Practitioner - General Surgery 4688995830 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Washington School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

100 E Warm Springs Ave
Suite B
Boise, ID 83712-6243
Phone (208) 381-6930

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
81.29
Promoting interoperability
100
Improvement activities
40
Cost
76.37

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ML60293216WAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC Surgery CurrentSince Jul 28, 2017 Accepting new patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Jul 28, 2017 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

100 E Warm Springs Ave
#B
Boise, ID 83712
Phone (208) 381-6930

100 E Warm Springs Ave
#A
Boise, ID 83712
Phone (208) 343-5910

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

1210 NW 16th St
Ste 1241
Fruitland, ID 83619

1210 NW 16th St
Fruitland, ID 83619
Phone (208) 452-8600

520 S Eagle Rd
Ste 1241
Meridian, ID 83642
Phone (208) 288-2255

9850 W St Lukes Dr
Ste 260
Nampa, ID 83687
Phone (208) 381-3915

Interoperability endpoints

  • Direct secure messaging: kkading87612@direct.slhs.org

Organizations & group practices 3

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": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344211200000",
    "number": "1447517735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 BROADWAY",
            "address_2": "SUITE WW-739",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981224379",
            "telephone_number": "206-386-6721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 BROADWAY",
            "address_2": "SUITE WW-739",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981224379",
            "telephone_number": "206-386-6721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KADING",
        "first_name": "KELLAN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-12",
        "last_updated": "2012-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "ML60293216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.