NPIMap

Individual provider Active NPI

Isaac Arnold Bohannon, MD

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Bellevue, WA
National Provider Identifier
1497964720
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X
License
MD60147213 Issued in WA
Practice address
11511 NE 10TH St
Bellevue, WA 98004-8578
Phone
(425) 502-3000
NPI assigned
May 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 27041 AL
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X MD60147213 WA Primary

Addresses

Primary practice location

11511 NE 10TH St
Bellevue, WA 98004-8578

Mailing address

11511 NE 10TH St
Bellevue, WA 98004-8578
Phone (425) 502-3000

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101203000372 WA Practitioner - Otolaryngology 3779634605 Reassigns benefits to 1 organization
I20240820003749 WA Practitioner - Hospice/Palliative Care 3779634605 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Drexel University College of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of WashingtonGroup PAC ID 9032022579, 1,519 clinicians

Practice addresses (Care Compare)

11511 NE 10TH St
Bellevue, WA 98004-8578
Phone (425) 502-3000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
27041ALMDOtolaryngology Physician
MD60147213WAMDPlastic Surgery within the Head & Neck (Otolaryngology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients
King County Public Hospital District No 2 CurrentSince Jun 8, 2024 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Feb 23, 2019 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
King County Public Hospital District No. 2 CurrentSince Jun 8, 2024 Accepting new patients
The Methodist Hospitals, Inc Past Accepting new patients

Locations

11511 NE 10th St
Hunts Point, WA 98004
Phone (425) 502-3000

12040 NE 128th St
#50
Kirkland, WA 98034
Phone (425) 899-1894

12040 NE 128th St
Kirkland, WA 98034
Phone (425) 899-1000

19379 7th Ave NE
Poulsbo, WA 98370
Phone (360) 394-1000

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: ibohannon166472@ghc.direct-ci.net

Organizations & group practices 11

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": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1497964720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 NE 10TH ST",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980048578",
            "telephone_number": "425-502-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11511 NE 10TH ST",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980048578",
            "telephone_number": "425-502-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOHANNON",
        "first_name": "ISAAC",
        "middle_name": "ARNOLD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "AL",
            "license": "27041",
            "primary": false
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "WA",
            "license": "MD60147213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "11511 NE 10th St",
            "city": "Bellevue",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980048578",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.