Individual provider Active NPI

Kristen Grace Bradley Kerekes, ARNP

  • Nurse Practitioner
  • Seattle, WA
National Provider Identifier
1528328101
Registry record updated May 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP61014374 Issued in WA
Practice address
5300 Tallman Ave NW
Seattle, WA 98107-3932
Phone
(206) 320-3514
Fax
(206) 781-6011
NPI assigned
May 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP61014374 WA Primary

Addresses

Primary practice location

5300 Tallman Ave NW
Seattle, WA 98107-3932

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476

Other identifiers 1

IdentifierTypeStateIssuer
2149564MedicaidWA

Other names 1

  • Kristen Grace Bradley Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120830000658 CA Practitioner - Nurse Practitioner 8921255654 Reassigns benefits to 1 organization
I20200312001575 WA Practitioner - Nurse Practitioner 8921255654 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Swedish Health ServicesGroup PAC ID 0244138196, 1,038 clinicians

Practice addresses (Care Compare)

5300 Tallman Nwave
Seattle, WA 98107-3932
Phone (206) 782-2700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
19196CAMDAcupuncturist
AP61014374WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Health Services CurrentSince Apr 10, 2023 Accepting new patients
Torrance Health Association Inc CurrentSince Jan 5, 2014 Accepting new patients
Swedish Health Services Past Accepting new patients

Locations

514 N Prospect Ave
Fl 4
Redondo Beach, CA 90277
Phone (310) 750-3300

23326 Hawthorne Blvd
Ste 200
Torrance, CA 90505
Phone (310) 257-7205

7320 216th St SW
Ste 310
Edmonds, WA 98026
Phone (425) 673-3800

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

5300 Tallman Ave NW
Seattle, WA 98107
Phone (206) 781-6209

Interoperability endpoints

  • Direct secure messaging: kkerekes2789805@wm.providencedirect.org

Organizations & group practices 3

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": "1337212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685059200000",
    "number": "1528328101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 TALLMAN AVE NW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981073932",
            "telephone_number": "206-320-3514",
            "fax_number": "206-781-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEREKES",
        "first_name": "KRISTEN",
        "middle_name": "GRACE BRADLEY",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-17",
        "last_updated": "2023-05-26",
        "certification_date": "2023-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61014374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2149564",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "BRADLEY",
            "middle_name": "GRACE",
            "credential": "ARNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.