Individual provider Active NPI

David M Koelle

  • Internal Medicine Physician
  • Seattle, WA
National Provider Identifier
1508942350
Registry record updated May 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD00025305 Issued in WA
Practice address
4245 Roosevelt Way NE
Seattle, WA 98105-6008
Phone
(206) 598-8750
NPI assigned
Oct 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X MD00025305 WA
Internal Medicine Physician 207R00000X MD00025305 WA Primary

Addresses

Primary practice location

4245 Roosevelt Way NE
Seattle, WA 98105-6008

Mailing address

PO Box 50095
Seattle, WA 98145-5095
Phone (206) 543-6420

Other identifiers 1

IdentifierTypeStateIssuer
1508942350MedicaidWA

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
I20100420000765 WA Practitioner - Internal MedicinePractitioner - Infectious Disease 2062549272 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Infectious Disease
Education
University of Washington School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Association of University PhysiciansGroup PAC ID 0446162697, 3,484 clinicians

Practice addresses (Care Compare)

325 9TH Ave
Seattle, WA 98104-2420
Phone (206) 731-3000

Hospital & facility affiliations

  • Harborview Medical Center Hospital, Seattle, WA, CCN 500064

Merit-based Incentive Payment System (MIPS)

Final score
93.85 of 100Reported as apm
Quality
74.6
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Association of University Physicians Internal Medicine CurrentSince Jul 1, 1992 Accepting new patients

Locations

4245 Roosevelt Way NE
Seattle, WA 98105
Phone (206) 598-4055

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

Interoperability endpoints

  • Direct secure messaging: dkoelle14218@direct.ehre.uwmedicine.org

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525651200000",
    "number": "1508942350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095",
            "telephone_number": "206-543-6420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4245 ROOSEVELT WAY NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981056008",
            "telephone_number": "206-598-8750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOELLE",
        "first_name": "DAVID",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2018-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "WA",
            "license": "MD00025305",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00025305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508942350",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.