Individual provider Active NPI

Sabrina Middleton, MD

  • Pediatrics Physician
  • Mukilteo, WA
National Provider Identifier
1467728964
Registry record updated Aug 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD60576781 Issued in WA
Practice address
4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275-5457
Phone
(425) 347-6330
Fax
(425) 347-6335
NPI assigned
Mar 29, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD60576781 WA Primary

Addresses

Primary practice location

4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275-5457

Mailing address

PO Box 3360
Portland, OR 97208-3360
Phone (866) 366-2983

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
I20150724010830 WA Practitioner - Pediatric Medicine 9931412541 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60576781WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services- Washington CurrentSince Jul 1, 2015 Accepting new patients
Providence Health & Services - Washington CurrentSince Jul 1, 2015 Accepting new patients
Providence Health & Services - Washington Pediatrics Past Accepting new patients

Locations

1321 Colby Ave
Ofc
Everett, WA 98201
Phone (425) 261-4076

12800 Bothell Everett Hwy
Everett, WA 98208
Phone (425) 316-5060

12800 Bothell Everett Hwy
Ste 190
Everett, WA 98208
Phone (425) 316-5160

4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330

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": "1332979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440028800000",
    "number": "1467728964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360",
            "telephone_number": "866-366-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4112 HARBOUR POINTE BLVD SW",
            "address_2": "STE 100",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982755457",
            "telephone_number": "425-347-6330",
            "fax_number": "425-347-6335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDDLETON",
        "first_name": "SABRINA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-29",
        "last_updated": "2015-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD60576781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mukilteo, WA

Sources for this page

Verify at the official NPI Registry.