NPIMap

Organization Active NPI

Pediatric Associates, Inc., P.S. Dba Allegro Pediatrics

  • Pediatrics Physician
  • Bellevue, WA
National Provider Identifier
1477624286
Registry record updated Oct 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATRIC ASSOCIATES, INC., P.S. DBA ALLEGRO PEDIATRICS
Practice address
2475 140TH Ave. NE. Building C
Bellevue, WA 98005
Phone
(425) 460-5601
Fax
(425) 460-5606
NPI assigned
Nov 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2020

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

Authorized official

Name
Brett Vandenberg
Title
Ceo
Phone
(425) 460-5643

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

2475 140TH Ave. NE. Building C
Bellevue, WA 98005

Mailing address

2475 140TH Ave. NE. Building C
Bellevue, WA 98005
Phone (425) 460-5601

Other names 1

  • Administration Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2295754Allegro Pediatrics2475 140TH Ave NE BLDG C, Bellevue, WA 98005Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Associates Inc PS Dba Allegro Pediatrics9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2475 140th Ave NE
Bldg C
Bellevue, WA 98005
Phone (425) 828-2257

3633 136th Pl SE
Ste 100
Bellevue, WA 98006

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602201600000",
    "number": "1477624286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2475 140TH AVE. NE. BUILDING C",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98005",
            "telephone_number": "425-460-5601",
            "fax_number": "425-460-5606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2475 140TH AVE. NE. BUILDING C",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98005",
            "telephone_number": "425-460-5601",
            "fax_number": "425-460-5606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ASSOCIATES, INC., P.S. DBA ALLEGRO PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A",
        "authorized_official_last_name": "VANDENBERG",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "425-460-5643"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Administration",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Administration",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.