NPIMap

Organization Active NPI

John H. Addison MD PS

Doing business as Northwest Geriatrics

  • Geriatric Medicine (Internal Medicine) Physician
  • Mercer Island, WA
National Provider Identifier
1497706774
Registry record updated Jan 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
JOHN H. ADDISON MD PS
Doing business as
Northwest Geriatrics
Practice address
9725 SE 36TH St.
Suite 214
Mercer Island, WA 98040
Phone
(206) 275-3588
Fax
(206) 275-2073
NPI assigned
May 12, 2006
Last updated
Jan 5, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2017

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

Authorized official

Name
Dr. John H. Addison, MDNPI 1659323087
Title
Owner
Phone
(206) 275-3588

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X NU
Geriatric Medicine (Internal Medicine) Physician 207RG0300X WA Primary

Addresses

Primary practice location

9725 SE 36TH St.
Suite 214
Mercer Island, WA 98040

Mailing address

PO Box 1526
Mercer Island, WA 98040
Phone (206) 275-3588

Other names 1

  • Northwest Geriatrics Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040206000718 WA Part B Supplier - Clinic/Group Practice 9335032887 Receives reassigned benefits from 21 practitioners
Practice locations: Mercer Island, WA

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
50D2157122Northwest Geriatrics9725 SE 36TH St Ste 214, Mercer Island, WA 98040Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Locations

1135 116th Ave NE
Ste 110
Bellevue, WA 98004
Phone (425) 289-3100

7707 SE 27th St
Ste 110
Mercer Island, WA 98040
Phone (206) 275-3588

7707 SE 27th St
Ste 214
Mercer Island, WA 98040
Phone (206) 275-3588

9725 SE 36th St
Ste 214
Mercer Island, WA 98040
Phone (206) 275-3588

Practitioners & affiliated clinicians

Practitioners 39

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483574400000",
    "number": "1497706774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1526",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "98040",
            "telephone_number": "206-275-3588",
            "fax_number": "206-275-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9725 SE 36TH ST.",
            "address_2": "SUITE 214",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "98040",
            "telephone_number": "206-275-3588",
            "fax_number": "206-275-2073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN H. ADDISON MD PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2017-01-05",
        "status": "A",
        "authorized_official_last_name": "ADDISON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-275-3588",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northwest Geriatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mercer Island, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.