Individual provider Active NPI

Kaalan E Johnson, MD

  • Pediatric Otolaryngology Physician
  • Seattle, WA
National Provider Identifier
1477715696
Registry record updated Jul 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
License
MD 60340296 Issued in WA
Practice address
4800 Sand Point Way NE
Oa.9.220 - Otolaryngology-ENT
Seattle, WA 98105-3901
Phone
(206) 987-3468
Fax
(206) 987-3925
NPI assigned
Jun 29, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Otolaryngology Physician 207YP0228X 35.097031 OH
Pediatric Otolaryngology Physician 207YP0228X MD 60340296 WA Primary

Addresses

Primary practice location

4800 Sand Point Way NE
Oa.9.220 - Otolaryngology-ENT
Seattle, WA 98105-3901

Mailing address

4800 Sand Point Way NE
Oa.9.220 - Otolaryngology-ENT
Seattle, WA 98105-3901
Phone (206) 987-3468

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
I20131009001355 WA Practitioner - Otolaryngology 4981873072 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Loma Linda University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4800 Sand Point Way NE
Seattle, WA 98105-3901
Phone (206) 526-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35.097031OHMDPediatric Otolaryngology Physician
MD 60340296WAMDPediatric Otolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Association of University Physicians CurrentSince Jan 1, 2016 Accepting new patients
The Association of Chrmc and University Physicians CurrentSince Aug 12, 2013 Accepting new patients
Association of CHMC and University Physicians CurrentSince Aug 12, 2013 Accepting new patients
Seattle Children'S Hospital Past Accepting new patients

Locations

900 Pacific Ave
Ste 100
Everett, WA 98201
Phone (425) 304-6080

4800 Sand Point Way NE
#83008
Seattle, WA 98105

4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000

4800 Sand Point Way NE
#9220
Seattle, WA 98105
Phone (206) 987-3468

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

325 9th Ave
Seattle, WA 98104
Phone (206) 731-3000

Interoperability endpoints

  • Direct secure messaging: kjohnson15383@direct.seattlechildrens.org

Organizations & group practices 4

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": "1214697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373673600000",
    "number": "1477715696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 SAND POINT WAY NE",
            "address_2": "OA.9.220 - OTOLARYNGOLOGY-ENT",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981053901",
            "telephone_number": "206-987-3468",
            "fax_number": "206-987-3925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 SAND POINT WAY NE",
            "address_2": "OA.9.220 - OTOLARYNGOLOGY-ENT",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981053901",
            "telephone_number": "206-987-3468",
            "fax_number": "206-987-3925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KAALAN",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-29",
        "last_updated": "2013-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "OH",
            "license": "35.097031",
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "WA",
            "license": "MD 60340296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.