Individual provider Active NPI

Christopher Y. Maeda, M.D.

  • Sports Medicine (Internal Medicine) Physician
  • Seattle, WA
National Provider Identifier
1457340648
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0010X
License
MD00042767 Issued in WA
Practice address
1200 12TH Ave S
Seattle, WA 98144-2712
Phone
(206) 326-2400
NPI assigned
Oct 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Internal Medicine) Physician 207RS0010X MD00042767 WA Primary

Addresses

Primary practice location

1200 12TH Ave S
Seattle, WA 98144-2712

Mailing address

1200 12TH Ave S
Seattle, WA 98144-2712
Phone (206) 326-2400

Other practice location 1

1909 214th St SE Ste 300
Bothell, WA 98021-4418
Phone (425) 412-7200

Other practice location 2

10416 5th Ave NE
Seattle, WA 98125-7402
Phone (206) 517-6700

Other practice location 3

12910 Totem Lake Blvd NE Ste 101
Kirkland, WA 98034-2901
Phone (425) 814-5000

Other identifiers 1

IdentifierTypeStateIssuer
8427379MedicaidWA

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address cmaeda1042815@wm.providencedirect.org Direct
Direct Messaging Address cmaeda1042815@wm.providencedirect.org Direct
Direct Messaging Address cmaeda1042815@wm.providencedirect.org Direct
Direct Messaging Address cmaeda1042815@wm.providencedirect.org Direct

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
I20051010000877 WA Practitioner - Sports MedicinePractitioner - Other (Physician)Practitioner - Family Practice 9133144017 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports Medicine
Education
Medical College of Wisconsin, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pacmed ClinicsGroup PAC ID 2466350657, 211 clinicians

Practice addresses (Care Compare)

10416 5TH Ave NE
Seattle, WA 98125-7402
Phone (206) 517-6700

1101 Madison St
Suite 301
Seattle, WA 98104-3599
Phone (206) 505-1300

1200 12TH Ave S
Seattle, WA 98144-2712
Phone (206) 326-2400

12910 Totem Lake Blvd NE
Suite 101
Kirkland, WA 98034-2901
Phone (425) 814-5000

1801 Lind Ave SW
Renton, WA 98057-3368
Phone (425) 227-3700

1909 214TH St SE
Suite 300
Bothell, WA 98021-4418
Phone (425) 412-7200

220 15TH Ave SE
Puyallup, WA 98372-3797
Phone (253) 435-3400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00042767WAMDSports Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pacmed Clinics CurrentSince Aug 22, 2005 Accepting new patients
Pacmed Clinics CurrentSince Aug 22, 2005 Accepting new patients
Pacmed Clinics Current Accepting new patients

Locations

1909 214th St SE
Ste 300
Bothell, WA 98021
Phone (425) 412-6335

12910 Totem Lake Blvd NE
Ste 101
Kirkland, WA 98034
Phone (425) 814-5000

220 15th Ave SE
Puyallup, WA 98372
Phone (253) 435-3400

601 S Carr Rd
Ste 100
Renton, WA 98055
Phone (425) 227-3700

10416 5th Ave NE
Seattle, WA 98125
Phone (206) 517-6667

1200 12th Ave S
Seattle, WA 98144
Phone (206) 326-2400

1101 Madison St
Ste 301
Seattle, WA 98104
Phone (206) 505-1101

Interoperability endpoints

  • Direct secure messaging: cmaeda1042815@wm.providencedirect.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.

NPI Registry JSON

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

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1457340648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 12TH AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981442712",
            "telephone_number": "206-326-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 12TH AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981442712",
            "telephone_number": "206-326-2400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1909 214th St SE Ste 300",
            "address_purpose": "LOCATION",
            "city": "Bothell",
            "state": "WA",
            "postal_code": "980214418",
            "country_code": "US",
            "telephone_number": "425-412-7200",
            "fax_number": "425-412-7342",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10416 5th Ave NE",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981257402",
            "country_code": "US",
            "telephone_number": "206-517-6700",
            "fax_number": "206-517-6665",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12910 Totem Lake Blvd NE Ste 101",
            "address_purpose": "LOCATION",
            "city": "Kirkland",
            "state": "WA",
            "postal_code": "980342901",
            "country_code": "US",
            "telephone_number": "425-814-5000",
            "fax_number": "425-814-5009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAEDA",
        "first_name": "CHRISTOPHER",
        "middle_name": "Y.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-19",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RS0010X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sports Medicine",
            "state": "WA",
            "license": "MD00042767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8427379",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmaeda1042815@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1200 12th Ave S",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981442712",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmaeda1042815@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "12910 Totem Lake Blvd NE Ste 101",
            "city": "Kirkland",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980342901",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmaeda1042815@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1909 214th St SE Ste 300",
            "city": "Bothell",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980214418",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmaeda1042815@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "10416 5th Ave NE",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981257402",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.