Individual provider Active NPI

Marianne Emmanuelle Dubard-Gault, M.D.

  • Clinical Genetics (M.D.) Physician
  • Seattle, WA
National Provider Identifier
1447678206
Registry record updated Nov 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Genetics (M.D.) PhysicianTaxonomy code 207SG0201X
License
MD60974578 Issued in WA
Practice address
1221 Madison St Ste 500
Seattle, WA 98104-1388
Phone
(206) 386-2552
Fax
(206) 215-3959
NPI assigned
Mar 30, 2014
Last updated
Nov 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD60974578 WA
Clinical Genetics (M.D.) Physician 207SG0201X MD60974578 WA Primary

Addresses

Primary practice location

1221 Madison St Ste 500
Seattle, WA 98104-1388

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476

Other identifiers 2

IdentifierTypeStateIssuer
1447678206MedicaidWA
2140453MedicaidWA

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
I20191010001825 WA Practitioner - Medical Genetics and GenomicsPractitioner - Internal Medicine 4587995279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Medical Genetics and GenomicsAlso: Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Swedish Health ServicesGroup PAC ID 0244138196, 1,038 clinicians

Practice addresses (Care Compare)

1221 Madison St
Suite 500
Seattle, WA 98104-1388
Phone (206) 215-5900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.1 of 100Reported as group
Quality
84.53
Promoting interoperability
100
Improvement activities
40
Cost
72.46

Merit-based Incentive Payment System (MIPS)

Final score
81.55 of 100Reported as group
Quality
63.9
Promoting interoperability
100
Improvement activities
40
Cost
74.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60974578WAMDClinical Genetics (M.D.) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Health Services Internal Medicine CurrentSince Apr 6, 2024 Accepting new patients

Locations

7320 216th St SW
Ste 310
Edmonds, WA 98026
Phone (425) 673-3800

1221 Madison St
Ste 500
Seattle, WA 98104
Phone (206) 215-5900

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

Interoperability endpoints

  • Direct secure messaging: mdubardgault3143086@wm.providencedirect.org
  • Direct secure messaging: mdubardgault924690@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 1

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": "1396137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730505600000",
    "number": "1447678206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 MADISON ST STE 500",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041388",
            "telephone_number": "206-386-2552",
            "fax_number": "206-215-3959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBARD-GAULT",
        "first_name": "MARIANNE",
        "middle_name": "EMMANUELLE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-30",
        "last_updated": "2024-11-02",
        "certification_date": "2024-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60974578",
            "primary": false
        },
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "WA",
            "license": "MD60974578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447678206",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2140453",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.