NPIMap

Organization Active NPI

Physical Medicine of Bellevue PLLC

  • General Practice Physician
  • Bellevue, WA
National Provider Identifier
1528316692
Registry record updated Feb 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
MD00039986 Issued in WA
Legal business name
PHYSICAL MEDICINE OF BELLEVUE PLLC
Practice address
555 108TH Ave NE Ste 1
Bellevue, WA 98004-5578
Phone
(425) 452-9280
Fax
(425) 452-9306
NPI assigned
Aug 21, 2012
Last updated
Feb 7, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2013

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

Authorized official

Name
Dr. Mikhail V. Makovski, MD
Title
Medical Director
Phone
(425) 452-9280

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X CH00003438 WA
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X CH60266885 WA
General Practice Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WG0000X AP60184962 WA
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X MD00039986 WA Primary
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X MA60147179 WA

Addresses

Primary practice location

555 108TH Ave NE Ste 1
Bellevue, WA 98004-5578

Mailing address

555 108TH Ave NE Ste 1
Bellevue, WA 98004-5578
Phone (425) 452-9280

National Provider Directory

National Provider Directory

Locations

1025 108th Ave NE
Bellevue, WA 98004
Phone (425) 974-7808

555 108th Ave NE
Ste 1
Bellevue, WA 98004
Phone (425) 452-9280

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1345507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1360195200000",
    "number": "1528316692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 108TH AVE NE STE 1",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980045578",
            "telephone_number": "425-452-9280",
            "fax_number": "425-452-9306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 108TH AVE NE STE 1",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980045578",
            "telephone_number": "425-452-9280",
            "fax_number": "425-452-9306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL MEDICINE OF BELLEVUE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-21",
        "last_updated": "2013-02-07",
        "status": "A",
        "authorized_official_last_name": "MAKOVSKI",
        "authorized_official_first_name": "MIKHAIL",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "425-452-9280",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00003438",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60266885",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, General Practice",
            "state": "WA",
            "license": "AP60184962",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "WA",
            "license": "MD00039986",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60147179",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.