Individual provider Active NPI

Alan Curtis Boudousquie, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Seattle, WA
National Provider Identifier
1467421610
Registry record updated Dec 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
MD00033212 Issued in WA
Practice address
747 Broadway
Seattle, WA 98122-4306
Phone
(206) 386-6000
NPI assigned
Mar 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2007

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X G85573 CA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD00033212 WA Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X G85573 CA
Cytopathology Physician 207ZC0500X MD00033212 WA

Addresses

Primary practice location

747 Broadway
Seattle, WA 98122-4306

Mailing address

PO Box 3941
Seattle, WA 98124-3941
Phone (206) 386-2676

Other identifiers 2

IdentifierTypeStateIssuer
203961OtherWALABOR & INDUSTRIES
8377129MedicaidWA

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
I20050922001066 WA Practitioner - Pathology 8123919230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Oregon Health Sciences University School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cellnetix Pathology PLLCGroup PAC ID 8224062971, 58 clinicians

Practice addresses (Care Compare)

12040 NE 128TH St
Ms 44
Kirkland, WA 98034-3013
Phone (844) 344-4209

1321 Colby Ave
Everett, WA 98201-1665
Phone (425) 261-2000

21601 76TH Ave W
Edmonds, WA 98026-7507
Phone (425) 640-4000

500 17TH Ave
Seattle, WA 98122-5711
Phone (206) 320-2000

747 Broadway
Seattle, WA 98122-4379
Phone (206) 386-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G85573CAMDCytopathology Physician
MD00033212WAMDCytopathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cellnetix Pathology, PLLC Cytopathology CurrentSince Aug 1, 2005 Accepting new patients
Cellnetix Pathology, PLLC Cytopathology Current Accepting new patients
Cellnetix Pathology, PLLC Anatomic Pathology & Clinical Pathology CurrentSince Aug 1, 2005 Accepting new patients
Yosemite Pathology Medical Group, in Past Accepting new patients
Cellnetix Pathology, PLLC Cytopathology Past Accepting new patients

Locations

1321 Colby Ave
Everett, WA 98201
Phone (425) 259-4413

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

800 W 5th Ave
Spokane, WA 99204
Phone (509) 458-5800

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.

Hospital & facility affiliations 5

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": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197936000000",
    "number": "1467421610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3941",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981243941",
            "telephone_number": "206-386-2676",
            "fax_number": "206-386-2709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 BROADWAY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981224306",
            "telephone_number": "206-386-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDOUSQUIE",
        "first_name": "ALAN",
        "middle_name": "CURTIS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2007-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "CA",
            "license": "G85573",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WA",
            "license": "MD00033212",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "G85573",
            "primary": false
        },
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "WA",
            "license": "MD00033212",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "203961",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8377129",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.