NPIMap

Individual provider Active NPI

Megan Marie Donnelly, PA

  • Physician Assistant
  • Seattle, WA
National Provider Identifier
1578815759
Registry record updated Feb 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60314307 Issued in WA
Practice address
4245 Roosevelt Way NE
Seattle, WA 98105-6008
Phone
(206) 598-4288
NPI assigned
Oct 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA60314307 WA Primary

Addresses

Primary practice location

4245 Roosevelt Way NE
Seattle, WA 98105-6008

Mailing address

5901 Steilacoom Blvd SW
Lakewood, WA 98499-3120
Phone (253) 572-2856

Other practice location 1

315 Martin Luther King Jr Way
Tacoma, WA 98405-4234
Phone (253) 403-8327

Other identifiers 1

IdentifierTypeStateIssuer
1578815759MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130111000108 WA Practitioner - Physician Assistant 4880612381 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pace Dermatology Associates, PLLCGroup PAC ID 5193995777, 14 clinicians
Cascade Eye and Skin Centers PCGroup PAC ID 4486541554, 47 clinicians

Practice addresses (Care Compare)

1910 S Meridian
Puyallup, WA 98371-7531
Phone (253) 572-2842

205 10TH St NE
Suite 119
Auburn, WA 98002-4045
Phone (253) 939-7911

7502 Lakewood Dr W
Suite a
Lakewood, WA 98499-8410
Phone (253) 572-2842

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Physician Assistant CurrentSince Nov 7, 2012 Accepting new patients
Tacoma Emergency Care Physicians, PLLC CurrentSince May 1, 2013 Accepting new patients
Multicare Health System CurrentSince Nov 7, 2012 Accepting new patients
Overlake Medical Clinics, LLC CurrentSince Nov 17, 2014 Accepting new patients
Issaquah Obstetrics and Gynecology PLLC Past Accepting new patients

Locations

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

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

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

17700 SE 272nd St
Kent, WA 98042
Phone (253) 372-6500

315 S K St
Tacoma, WA 98405
Phone (253) 403-1291

Interoperability endpoints

  • Direct secure messaging: mdonnelly@directaddress.net

Organizations & group practices 10

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": "1349913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1578815759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 STEILACOOM BLVD SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993120",
            "telephone_number": "253-572-2856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4245 ROOSEVELT WAY NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981056008",
            "telephone_number": "206-598-4288"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 Martin Luther King Jr Way",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984054234",
            "country_code": "US",
            "telephone_number": "253-403-8327",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "MEGAN",
        "middle_name": "MARIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-11",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60314307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1578815759",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.