Individual provider Active NPI

Maryan Gelle

  • Family Medicine Physician
  • Bellevue, WA
National Provider Identifier
1609519388
Registry record updated Apr 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD70033991 Issued in WA
Practice address
1200 112TH Ave NE
Bellevue, WA 98004-3732
Phone
(425) 453-1039
Fax
(425) 453-8955
NPI assigned
Apr 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD70033991 WA Primary

Addresses

Primary practice location

1200 112TH Ave NE
Bellevue, WA 98004-3732

Mailing address

7600 Evergreen Way
Everett, WA 98203-6421
Phone (206) 860-5414

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
I20251125004246 WA Practitioner - Family Practice 5698267797 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Care Washington PLLCGroup PAC ID 6406752153, 684 clinicians

Practice addresses (Care Compare)

1200 112TH Ave NE
Suite C160
Bellevue, WA 98004-3742
Phone (425) 453-1039

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD70033991WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Polyclinic PLLC Family Medicine CurrentSince Dec 1, 2025 Accepting new patients
The Polyclinic PLLC Family Medicine CurrentSince Dec 1, 2025 Accepting new patients
Optum Care Washington PLLC Family Medicine CurrentSince Dec 1, 2025 Accepting new patients
Optum Care Washington PLLC Family Medicine CurrentSince Dec 1, 2025 Accepting new patients
Optum Care Washington PLLC Past Accepting new patients
The Polyclinic PLLC Family Medicine Past Accepting new patients

Locations

1200 112th Ave NE
Ste C160
Bellevue, WA 98004
Phone (425) 453-1039

1200 112th Ave NE
Ste C187
Bellevue, WA 98004
Phone (425) 457-4900

1200 112th Ave NE
Bellevue, WA 98004
Phone (425) 453-1039

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

1145 Broadway
Seattle, WA 98122

9709 3rd Ave NE
Seattle, WA 98115
Phone (206) 525-5777

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

1812 S J St
Ste 102
Tacoma, WA 98405
Phone (253) 552-4900

Interoperability endpoints

  • Direct secure messaging: mgelle26631@direct.xtensys.com

Organizations & group practices 6

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": "1650326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776816000000",
    "number": "1609519388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 EVERGREEN WAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982036421",
            "telephone_number": "206-860-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 112TH AVE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043732",
            "telephone_number": "425-453-1039",
            "fax_number": "425-453-8955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELLE",
        "first_name": "MARYAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-19",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD70033991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.