Individual provider Active NPI

Vincent M. Koike, D.O.

  • Family Medicine Physician
  • Everett, WA
National Provider Identifier
1497843213
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP00001265 Issued in WA
Practice address
7601 Evergreen Way, B-6
Everett, WA 98203
Phone
(425) 353-9191
Fax
(425) 353-0015
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X OP00001265 WA Primary

Addresses

Primary practice location

7601 Evergreen Way, B-6
Everett, WA 98203

Mailing address

14517 62ND Dr SE
Everett, WA 98208-9391
Phone (425) 337-5042

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
I20040422000441 WA Practitioner - Family Practice 0749276038 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rina Roy MDPCGroup PAC ID 1658367057, 2 clinicians

Practice addresses (Care Compare)

9505 19TH Ave SE
Suite 100
Everett, WA 98208-3843
Phone (425) 225-6721

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care of Washington, P.S. Single Specialty CurrentSince Nov 5, 2018 Accepting new patients
American Current Care of Washington, P.S. Single Specialty CurrentSince Nov 5, 2018 Accepting new patients
American Current Care of Washington, P.S. Single Specialty Current Accepting new patients

Locations

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

1925 140th Ave NE
Bellevue, WA 98005
Phone (425) 865-8060

3101 111th St SW
Unit Tu
Everett, WA 98204
Phone (425) 267-0299

16690 Redmond Way
Redmond, WA 98052
Phone (425) 882-0100

9222 N Newport Hwy
Ste 1
Spokane, WA 99218
Phone (509) 467-4545

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1497843213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14517 62ND DR SE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982089391",
            "telephone_number": "425-337-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 EVERGREEN WAY, B-6",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "98203",
            "telephone_number": "425-353-9191",
            "fax_number": "425-353-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOIKE",
        "first_name": "VINCENT",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP00001265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.