Organization Active NPI

Samuel K. Seto MD PLLC

  • Specialist
  • Edmonds, WA
National Provider Identifier
1497827711
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD00032689 Issued in WA
Legal business name
SAMUEL K. SETO MD PLLC
Practice address
21911 76TH Ave W
Suite 101
Edmonds, WA 98026-7903
Phone
(425) 774-7723
Fax
(425) 778-2788
NPI assigned
Nov 14, 2006
Last updated
Nov 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

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

Authorized official

Name
Dr. Samuel K Seto, MDNPI 1144300542
Title
Owner
Phone
(425) 774-7723

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD00032689 WA Primary

Addresses

Primary practice location

21911 76TH Ave W
Suite 101
Edmonds, WA 98026-7903

Mailing address

21911 76TH Ave W
Suite 101
Edmonds, WA 98026-7903
Phone (425) 774-7723

Other identifiers 2

IdentifierTypeStateIssuer
0151324OtherWALABOR AND INDUSTRIES
7701204MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040319001272 WA Part B Supplier - Clinic/Group Practice 5294625356 Receives reassigned benefits from 3 practitioners
Practice locations: Edmonds, WA
O20100930080311 WA DME Supplier - Physician - Ophthalmology 5294625356 Practice locations: Edmonds, WA

National Provider Directory

National Provider Directory

Locations

21616 76th Ave W
#105
Edmonds, WA 98026
Phone (425) 774-7723

21911 76th Ave W
Edmonds, WA 98026
Phone (425) 775-6651

21911 76th Ave W
Ste 101
Edmonds, WA 98026
Phone (425) 744-7723

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699920000000",
    "number": "1497827711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21911 76TH AVE W",
            "address_2": "SUITE 101",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267903",
            "telephone_number": "425-774-7723",
            "fax_number": "425-778-2788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21911 76TH AVE W",
            "address_2": "SUITE 101",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267903",
            "telephone_number": "425-774-7723",
            "fax_number": "425-778-2788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL K. SETO MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A",
        "authorized_official_last_name": "SETO",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-774-7723",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MD00032689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0151324",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7701204",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.