Individual provider Active NPI

Joseph Wyham NG, DPM

  • Foot & Ankle Surgery Podiatrist
  • Seattle, WA
National Provider Identifier
1609958586
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
P000000319 Issued in WA
Practice address
611 12TH Ave S Ste 200
Seattle, WA 98144-1911
Phone
(206) 324-9360
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X P000000319 WA Primary

Addresses

Primary practice location

611 12TH Ave S Ste 200
Seattle, WA 98144-1911

Mailing address

611 12TH Ave S
Ste 200
Seattle, WA 98144-1911
Phone (206) 324-9360

Other identifiers 3

IdentifierTypeStateIssuer
1297506MedicaidWA
71502OtherWAL & I
NG0036OtherREGENCE

Other names 1

  • Wyham Joseph NG Professional name

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120206000205 WA Practitioner - Podiatry 7517124449 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
California School of Podiatric Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
International Community Health ServicesGroup PAC ID 5799695672, 95 clinicians

Practice addresses (Care Compare)

16549 Aurora Ave N
Shoreline, WA 98133-5308
Phone (206) 533-2600

3815 S Othello St
FL 2
Seattle, WA 98118-3510
Phone (206) 788-3500

718 8TH Ave S
Seattle, WA 98104-3006
Phone (206) 788-3505

720 8TH Ave S
Suite 100
Seattle, WA 98104-3033
Phone (206) 788-3700

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P000000319WAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Seattle Indian Health Board CurrentSince Jul 8, 2017 Accepting new patients
International Community Health Services CurrentSince Oct 21, 2017 Accepting new patients
International Community Health Services Current Accepting new patients
International Community Health Services CurrentSince Oct 21, 2017 Accepting new patients
Seattle Indian Health Board CurrentSince Jul 8, 2017 Accepting new patients
East Hill Foot and Ankle Clinic Foot & Ankle Surgery PastSince Mar 1, 2009 Accepting new patients

Locations

1050 140th Ave NE
Bellevue, WA 98005
Phone (425) 373-3000

611 12th Ave S
Ste 200
Seattle, WA 98144
Phone (206) 324-9360

611 12th Ave S
Seattle, WA 98144
Phone (206) 324-9360

720 8th Ave S
Seattle, WA 98104
Phone (206) 788-3770

3815 S Othello St
Fl 2
Seattle, WA 98118
Phone (206) 788-3500

Interoperability endpoints

  • Direct secure messaging: wng348599@direct.ochin.org
  • Direct secure messaging: jng1186632@wm.providencedirect.org

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": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1609958586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 12TH AVE S",
            "address_2": "STE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981441911",
            "telephone_number": "206-324-9360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 12TH AVE S STE 200",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981441911",
            "telephone_number": "206-324-9360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NG",
        "first_name": "JOSEPH",
        "middle_name": "WYHAM",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WA",
            "license": "P000000319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1297506",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "71502",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "NG0036",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WYHAM",
            "last_name": "NG",
            "middle_name": "JOSEPH",
            "credential": "DPM",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.