Individual provider Active NPI

Alexander P Kallas, MD

  • Emergency Medicine Physician
  • Seattle, WA
National Provider Identifier
1548324577
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD00044113 Issued in WA
Practice address
500 17TH Ave
Seattle, WA 98122-5711
Phone
(206) 320-2111
Fax
(206) 320-3396
NPI assigned
Dec 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD00044113 WA Primary

Addresses

Primary practice location

500 17TH Ave
Seattle, WA 98122-5711

Mailing address

PO Box 84026
Seattle, WA 98124-8426
Phone (206) 320-2111

Other practice location 1

10452 Silverdale Way NW
Silverdale, WA 98383-9411
Phone (360) 307-7300

Other identifiers 2

IdentifierTypeStateIssuer
8406688MedicaidWA
0189706OtherWALABOR AND INDUSTRIES

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync Health Information Exchange (HIE)

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
I20040921000937 WA Practitioner - Emergency Medicine 8820066483 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Northwestern University Feinberg Medical School, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

209 Martin Luther King Jr Way
Tacoma, WA 98405-4265
Phone (253) 596-3300

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington Current Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Jan 7, 2020 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Jan 7, 2020 Accepting new patients
Jefferson County Public Hospital District No 2 CurrentSince Oct 1, 2014 Accepting new patients

Locations

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

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

10452 Silverdale Way NW
Silverdale, WA 98383
Phone (360) 307-7300

209 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 596-3300

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: akallas236410@ghc.direct-ci.net

Organizations & group practices 5

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": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1548324577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 84026",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981248426",
            "telephone_number": "206-320-2111",
            "fax_number": "206-320-3396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 17TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225711",
            "telephone_number": "206-320-2111",
            "fax_number": "206-320-3396"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10452 Silverdale Way NW",
            "address_purpose": "LOCATION",
            "city": "Silverdale",
            "state": "WA",
            "postal_code": "983839411",
            "country_code": "US",
            "telephone_number": "360-307-7300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KALLAS",
        "first_name": "ALEXANDER",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD00044113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8406688",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "0189706",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10452 Silverdale Way NW",
            "city": "Silverdale",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983839411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.