Individual provider Active NPI

John T Holder, MD

  • Cardiovascular Disease Physician
  • Bellevue, WA
National Provider Identifier
1518994003
Registry record updated Apr 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD00014445 Issued in WA
Practice address
1414 116TH Ave NE
Suite E
Bellevue, WA 98004-3801
Phone
(425) 455-9555
Fax
(425) 454-2044
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD00014445 WA Primary

Addresses

Primary practice location

1414 116TH Ave NE
Suite E
Bellevue, WA 98004-3801

Mailing address

2701 1St Ave
Suite 320
Seattle, WA 98121-1123
Phone (206) 448-2516

Other identifiers 2

IdentifierTypeStateIssuer
0178978OtherWAL & I
1092295MedicaidWA

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
I20040419000240 WA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 6305830597 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Overlake Medical Clinics LLC CurrentSince Jun 20, 2011 Accepting new patients
Overlake Medical Clinics, LLC CurrentSince Jun 20, 2011 Accepting new patients
Bellevue Cardiology Clinic PLLC Cardiovascular Disease Past Accepting new patients
Issaquah Obstetrics and Gynecology PLLC Past Accepting new patients
Bellevue Heart and Vascular Center, LLC Cardiovascular Disease Past Accepting new patients
Seattle Heart and Vascular Center, LLC Cardiovascular Disease Past Accepting new patients

Locations

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

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

Organizations & group practices 6

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": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302652800000",
    "number": "1518994003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 1ST AVE",
            "address_2": "SUITE 320",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981211123",
            "telephone_number": "206-448-2516",
            "fax_number": "206-448-6473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 116TH AVE NE",
            "address_2": "SUITE E",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043801",
            "telephone_number": "425-455-9555",
            "fax_number": "425-454-2044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLDER",
        "first_name": "JOHN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2011-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WA",
            "license": "MD00014445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "0178978",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1092295",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.