NPIMap

Individual provider Active NPI

Michelle Leno Gordon, MD

  • Internal Medicine Physician
  • Kirkland, WA
National Provider Identifier
1487697975
Registry record updated Jun 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD00039003 Issued in WA
Practice address
12040 NE 128TH St
Ms #105
Kirkland, WA 98034-3013
Phone
(425) 899-2560
Fax
(425) 899-2079
NPI assigned
Jun 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD00039003 WA Primary

Addresses

Primary practice location

12040 NE 128TH St
Ms #105
Kirkland, WA 98034-3013

Mailing address

PO Box 34036
Seattle, WA 98124-1036
Phone (425) 899-3292

Other identifiers 3

IdentifierTypeStateIssuer
8857GOOtherWABSWA
0143740OtherWALIWA
8276743MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040309001209 WA Practitioner - Internal Medicine 0941198097 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Washington School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12033 NE 130TH LN
Suite 120
Kirkland, WA 98034-3052
Phone (425) 899-2160

12040 NE 128TH St
Kirkland, WA 98034-3013

12040 NE 128TH St Ms
Suite 55
Kirkland, WA 98034-3013

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.73 of 100Reported as apm
Quality
73.46
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00039003WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No. 2 CurrentSince Jun 17, 2008 Accepting new patients
Public Hospital District 1 of Snohomish County CurrentSince Jun 1, 2016 Accepting new patients
King County Public Hospital District No 2 Internal Medicine CurrentSince Jun 17, 2008 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
Public Hospital District No 1 of Snohomish County CurrentSince Jun 1, 2016 Accepting new patients
Northwest Hospital Medicine Physicians LLC Internal Medicine Past Accepting new patients
King County Public Hospital District No. 2 Past Accepting new patients

Locations

12039 NE 128th St
Ste 300
Kirkland, WA 98034
Phone (425) 899-3123

12040 NE 128th St
Ofc
Kirkland, WA 98034

12040 NE 128th St
#105
Kirkland, WA 98034
Phone (425) 899-2560

14701 179th Ave SE
Monroe, WA 98272
Phone (360) 794-1409

Organizations & group practices 7

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 4

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245196800000",
    "number": "1487697975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34036",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241036",
            "telephone_number": "425-899-3292",
            "fax_number": "425-899-3269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12040 NE 128TH ST",
            "address_2": "MS #105",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343013",
            "telephone_number": "425-899-2560",
            "fax_number": "425-899-2079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORDON",
        "first_name": "MICHELLE",
        "middle_name": "LENO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-13",
        "last_updated": "2009-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00039003",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSWA",
            "identifier": "8857GO",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIWA",
            "identifier": "0143740",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8276743",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.