Bellevue Podiatric Physicians PLLC

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

BELLEVUE PODIATRIC PHYSICIANS PLLC

Practice address

1609 116TH Ave NE
Bellevue, WA 98004

Phone

(425) 283-5093

Fax

(425) 283-5095

NPI assigned

Sep 7, 2006

Last updated

Feb 27, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Suzanne M Wilson, DPMNPI 1811984248

Title

Physican/Owner

Phone

(425) 283-5093

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA2 enrollments

Enrollment records 2

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/6873/brand/1/csg/1/fhir/r4

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Suzanne M Wilson, DPM

  • Podiatrist
  • Bellevue, WA
  • NPI 1811984248
  Medicare reassignment Care Compare group Authorized official
• Molly Ichikawa, DPM

  • Podiatrist
  • Bellevue, WA
  • NPI 1003418427
  Medicare reassignment Care Compare group NPD
• Deborah Jean Ketterer, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Renton, WA
  • NPI 1063584498
  Medicare reassignment Care Compare group NPD
• Douglas J Ichikawa, DPM

  • Podiatrist
  • Bellevue, WA
  • NPI 1124099601
  Medicare reassignment Care Compare group
• Khanh Le, DPM

  • Foot & Ankle Surgery Podiatrist
  • Sammamish, WA
  • NPI 1902280431

  Single Specialty

  Medicare reassignment NPD
• Daniel Adam Lowinger, DPM

  • Foot & Ankle Surgery Podiatrist
  • Seattle, WA
  • NPI 1285634519
  Medicare reassignment

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551225600000",
    "number": "1467555888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1609 116TH AVE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98004",
            "telephone_number": "425-283-5093",
            "fax_number": "425-283-5095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1609 116TH AVE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98004",
            "telephone_number": "425-283-5093",
            "fax_number": "425-283-5095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLEVUE PODIATRIC PHYSICIANS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2019-02-27",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICAN/OWNER",
        "authorized_official_telephone_number": "425-283-5093",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7122096",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bellevue Orthopedic Physicians PLLC (Bellevue Hand Surgery)
• Bellevue Pain and Wellness PLLC
• Bellevue Park Dental
• Bellevue Physiatry and Electrodiagnosis LLC
• Bellevue Plastic Surgery Center (Newvue Plastic Surgery PC)
• Bellevue Podiatry Inc.
• Bellevue Psychotherapy, PS LTD
• Bellevue Rehab Associates, PLLC
• Bellevue School District
• Bellevue School District

• Podiatrist in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Podiatrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.