Individual provider Active NPI

Shelby Ann Reiter, MD

  • Surgery Physician
  • Edmonds, WA
National Provider Identifier
1477084770
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD61166767 Issued in WA
Practice address
21616 76TH Ave W Ste 201a
Edmonds, WA 98026-7512
Phone
(425) 673-3400
Fax
(425) 673-3401
NPI assigned
Mar 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD61166767 WA Primary

Addresses

Primary practice location

21616 76TH Ave W Ste 201a
Edmonds, WA 98026-7512

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
2084067MedicaidWA

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
I20220823001490 WA Practitioner - General Surgery 1658641998 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Creighton University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Swedish Health ServicesGroup PAC ID 0244138196, 1,038 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

  • Swedish Edmonds Hospital Hospital, Edmonds, WA, CCN 500026

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD61166767WAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services-Washington CurrentSince Feb 1, 2024 Accepting new patients
Providence Health & Services- Washington CurrentSince Feb 1, 2024 Accepting new patients
Swedish Health Services Surgery CurrentSince Aug 22, 2022 Accepting new patients
Swedish Health Services Surgery PastSince Dec 13, 2022 Accepting new patients
Swedish Edmonds Past Accepting new patients

Locations

21616 76th Ave W
Ste 201A
Edmonds, WA 98026
Phone (425) 673-3400

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

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

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

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

747 Broadway
Ste WW739
Seattle, WA 98122
Phone (206) 386-2123

380 Chase Ave
Walla Walla, WA 99362
Phone (509) 526-3333

Interoperability endpoints

  • Direct secure messaging: sreiter1043045@wm.providencedirect.org

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 2

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": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1477084770",
    "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": "21616 76TH AVE W STE 201A",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267512",
            "telephone_number": "425-673-3400",
            "fax_number": "425-673-3401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REITER",
        "first_name": "SHELBY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-27",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD61166767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2084067",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

Verify at the official NPI Registry.