Individual provider Active NPI

Harrison A Kalodimos, MD

  • Family Medicine Physician
  • Shoreline, WA
National Provider Identifier
1487016689
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60855811 Issued in WA
Practice address
604 NW Richmond Beach Rd
Shoreline, WA 98177-3122
Phone
(206) 533-2900
Fax
(206) 533-2901
NPI assigned
Mar 26, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD60855811 WA Primary

Addresses

Primary practice location

604 NW Richmond Beach Rd
Shoreline, WA 98177-3122

Mailing address

604 NW Richmond Beach Rd
Shoreline, WA 98177-3122
Phone (206) 533-2900

Other practice location 1

21600 Highway 99 Ste 240
Edmonds, WA 98026-5139
Phone (425) 673-3500

Other identifiers 1

IdentifierTypeStateIssuer
1487016689MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hkalodimos1042077@wm.providencedirect.org Direct

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
I20191022003753 WA Practitioner - Family Practice 3870872690 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Perelman School of Med at the University of Pennsylvania, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians
Swedish Health ServicesGroup PAC ID 9537072814, 384 clinicians

Practice addresses (Care Compare)

2600 Compass Rd
Glenview, IL 60026-8001

604 NW Richmond Beach Rd
Shoreline, WA 98177-3122
Phone (206) 533-2900

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60855811WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Health Services Family Medicine Current Accepting new patients
Swedish Health Services Family Medicine CurrentSince Sep 30, 2019 Accepting new patients
Swedish Health Services CurrentSince Sep 30, 2019 Accepting new patients

Locations

21600 Highway 99
Ste 240
Edmonds, WA 98026
Phone (206) 774-2632

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

1401 Madison St
Ste 100
Seattle, WA 98104
Phone (206) 386-6111

800 5th Ave
Ste 600
Seattle, WA 98104

420 NE 72nd St
Ste A
Seattle, WA 98115
Phone (206) 297-5077

2450 33rd Ave W
Ste 100
Seattle, WA 98199
Phone (206) 320-3364

604 NW Richmond Beach Rd
Shoreline, WA 98177
Phone (206) 533-2900

Interoperability endpoints

  • Direct secure messaging: hkalodimos1042077@wm.providencedirect.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.

Hospital & facility affiliations 5

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": "1458950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1487016689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 NW RICHMOND BEACH RD",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981773122",
            "telephone_number": "206-533-2900",
            "fax_number": "206-533-2901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 NW RICHMOND BEACH RD",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981773122",
            "telephone_number": "206-533-2900",
            "fax_number": "206-533-2901"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21600 Highway 99 Ste 240",
            "address_purpose": "LOCATION",
            "city": "Edmonds",
            "state": "WA",
            "postal_code": "980265139",
            "country_code": "US",
            "telephone_number": "425-673-3500",
            "fax_number": "425-673-3501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KALODIMOS",
        "first_name": "HARRISON",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-26",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60855811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487016689",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hkalodimos1042077@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "21600 Highway 99 Ste 240",
            "city": "Edmonds",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980265139",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

Verify at the official NPI Registry.