Individual provider Active NPI

Jordan Daryoush Kamal, ARNP

  • Registered Nurse
  • Kirkland, WA
National Provider Identifier
1528694106
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN60213730 Issued in WA
Practice address
12040 NE 128TH St
Kirkland, WA 98034-3013
Phone
(425) 447-2164
NPI assigned
Mar 16, 2020
Last updated
Apr 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP61311416 WA
Registered Nurse 163W00000X RN60213730 WA Primary

Addresses

Primary practice location

12040 NE 128TH St
Kirkland, WA 98034-3013

Mailing address

1959 NE Pacific St
Seattle, WA 98195-0001

Other practice location 1

9801 Frontier Ave SE
Snoqualmie, WA 98065-5200
Phone (425) 831-2300

Other practice location 2

14269 120th Pl NE
Kirkland, WA 98034-1425
Phone (425) 985-2155

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221205003372 WA Practitioner - Nurse Practitioner 1658740170 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Washington School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12040 NE 128TH St
Ms 105
Kirkland, WA 98034-3013
Phone (425) 899-2560

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.74 of 100Reported as group
Quality
78.83
Promoting interoperability
100
Improvement activities
40
Cost
66.97

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

State licenses

LicenseStateTypeSpecialty
RN60213730WAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No. 2 CurrentSince Dec 1, 2022 Accepting new patients
Public Hospital District No 4 King County Washington CurrentSince Dec 6, 2022 Accepting new patients
King County Public Hospital District No. 2 Current Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
Public Hospital District No 4 King County Washington CurrentSince Dec 6, 2022 Accepting new patients
King County Public Hospital District No 2 CurrentSince Dec 1, 2022 Accepting new patients
Public Hospital District No 4, King County Wa Past Accepting new patients

Locations

1909 214th St SE
Ste 110
Bothell, WA 98021
Phone (425) 488-4988

14720 Main St NE
Ste 109
Duvall, WA 98019
Phone (425) 788-4889

12039 NE 128th St
Ste 300
Kirkland, WA 98034
Phone (425) 899-3123

12040 NE 128th St
Kirkland, WA 98034
Phone (425) 899-1000

12040 NE 128th St
#105
Kirkland, WA 98034
Phone (425) 899-2560

12040 NE 128th St
#50
Kirkland, WA 98034
Phone (425) 899-1894

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

9801 Frontier Ave SE
Snoqualmie, WA 98065
Phone (425) 831-2300

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1584316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1528694106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981950001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12040 NE 128TH ST",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343013",
            "telephone_number": "425-447-2164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9801 Frontier Ave SE",
            "address_purpose": "LOCATION",
            "city": "Snoqualmie",
            "state": "WA",
            "postal_code": "980655200",
            "country_code": "US",
            "telephone_number": "425-831-2300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14269 120th Pl NE",
            "address_purpose": "LOCATION",
            "city": "Kirkland",
            "state": "WA",
            "postal_code": "980341425",
            "country_code": "US",
            "telephone_number": "425-985-2155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAMAL",
        "first_name": "JORDAN",
        "middle_name": "DARYOUSH",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-16",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61311416",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN60213730",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.