Individual provider Active NPI

Craig Vaughan Tuohy, M.D.

  • Cardiovascular Disease Physician
  • Bellevue, WA
National Provider Identifier
1528405933
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD191906 Issued in OR
Practice address
1135 116TH Ave NE
Suite 600
Bellevue, WA 98004
Phone
(425) 454-2656
Fax
(425) 455-2620
NPI assigned
May 24, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD191906 OR
Cardiovascular Disease Physician 207RC0000X MD191906 OR Primary

Addresses

Primary practice location

1135 116TH Ave NE
Suite 600
Bellevue, WA 98004

Mailing address

Ms 315010
PO Box 3947
Seattle, WA 98124-3947
Phone (425) 688-5670

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
I20200818002614 WA Practitioner - Cardiovascular Disease (Cardiology) 0941597033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2013
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)

1035 116TH Ave NE
Bellevue, WA 98004-4604
Phone (425) 688-5072

Hospital & facility affiliations

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
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Overlake Medical Clinics, LLC CurrentSince Jan 31, 2021 Accepting new patients
Overlake Medical Clinics LLC CurrentSince Aug 1, 2020 Accepting new patients
Issaquah Obstetrics and Gynecology PLLC Past Accepting new patients

Locations

1135 116th Ave NE
Ste 600
Bellevue, WA 98004
Phone (425) 454-2656

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

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

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

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 4

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": "1369353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1528405933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MS 315010",
            "address_2": "PO BOX 3947",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981243947",
            "telephone_number": "425-688-5670",
            "fax_number": "425-635-6388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 116TH AVE NE",
            "address_2": "SUITE 600",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98004",
            "telephone_number": "425-454-2656",
            "fax_number": "425-455-2620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUOHY",
        "first_name": "CRAIG",
        "middle_name": "VAUGHAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-24",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD191906",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OR",
            "license": "MD191906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.