Individual provider Active NPI

Ann O Padilla, DNP, ANP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Auburn, WA
National Provider Identifier
1508931643
Registry record updated Jul 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP30007489 Issued in WA
Practice address
4240 Auburn Way N
Auburn, WA 98002
Phone
(253) 876-8900
Fax
(253) 876-8910
NPI assigned
Nov 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP30007489 WA Primary

Addresses

Primary practice location

4240 Auburn Way N
Auburn, WA 98002

Mailing address

6400 Southcenter Blvd
Tukwila, WA 98188-2547
Phone (206) 901-2000

Other identifiers 1

IdentifierTypeStateIssuer
9651258MedicaidWA

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070118000261 WA Practitioner - Nurse Practitioner 7618978651 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Washington School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Overlake Medical Clinics LLCGroup PAC ID 7012808827, 423 clinicians

Practice addresses (Care Compare)

1750 112TH Ave NE
Suite B102
Bellevue, WA 98004-3772
Phone (425) 688-5460

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP30007489WAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No. 2 CurrentSince Apr 21, 2019 Accepting new patients
Overlake Medical Clinics LLC CurrentSince Dec 10, 2018 Accepting new patients
Overlake Medical Clinics, LLC CurrentSince Dec 10, 2018 Accepting new patients
King County Public Hospital District No. 2 CurrentSince Apr 21, 2019 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
Puget Sound Allergy Asthma and Immunology Past Accepting new patients
Issaquah Obstetrics and Gynecology PLLC Past Accepting new patients

Locations

1750 112th Ave NE
Ste B102
Bellevue, WA 98004
Phone (425) 688-5460

6520 226th Pl SE
Ste 150
Issaquah, WA 98027
Phone (425) 688-5777

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

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531180800000",
    "number": "1508931643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 SOUTHCENTER BLVD",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981882547",
            "telephone_number": "206-901-2000",
            "fax_number": "206-901-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4240 AUBURN WAY N",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "98002",
            "telephone_number": "253-876-8900",
            "fax_number": "253-876-8910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADILLA",
        "first_name": "ANN",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "DNP,  ANP, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-22",
        "last_updated": "2018-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP30007489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9651258",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, WA

Sources for this page

Verify at the official NPI Registry.