Individual provider Active NPI

Michael W. Piepkorn, M.D.

  • Dermatopathology Physician
  • Bellevue, WA
National Provider Identifier
1609975226
Registry record updated Oct 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology PhysicianTaxonomy code 207ND0900X
License
MD00014558 Issued in WA
Practice address
2330 130TH Ave NE Ste 201
Bellevue, WA 98005-1756
Phone
(425) 455-9945
Fax
(425) 455-9947
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD00014558 WA
Dermatopathology Physician 207ND0900X MD00014558 WA Primary

Addresses

Primary practice location

2330 130TH Ave NE Ste 201
Bellevue, WA 98005-1756

Mailing address

2330 130TH Ave NE Ste 201
Bellevue, WA 98005-1756
Phone (425) 455-9945

Other identifiers 1

IdentifierTypeStateIssuer
7099864MedicaidWA

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
I20040330000503 WA Practitioner - DermatologyPractitioner - Pathology 8820080112 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
DermatologyAlso: Pathology
Education
University of Minnesota Medical School, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatopatholoty Northwest PLLCGroup PAC ID 3173516101, 5 clinicians

Practice addresses (Care Compare)

2330 130TH Ave NE
Suite 201
Bellevue, WA 98005-1756
Phone (425) 455-9945

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatopatholoty Northwest PLLC Dermatopathology CurrentSince Mar 1, 2000 Accepting new patients
Hao Wang MD PLLC Dermatology PastSince Dec 1, 2002 Accepting new patients
John S Walsh MD PLLC Dermatology PastSince Mar 1, 2000 Accepting new patients

Locations

2330 130th Ave NE
Ste 201
Bellevue, WA 98005
Phone (425) 455-9945

Organizations & group practices 3

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191542400000",
    "number": "1609975226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 130TH AVE NE STE 201",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980051756",
            "telephone_number": "425-455-9945",
            "fax_number": "425-455-9947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 130TH AVE NE STE 201",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980051756",
            "telephone_number": "425-455-9945",
            "fax_number": "425-455-9947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIEPKORN",
        "first_name": "MICHAEL",
        "middle_name": "W.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "MD00014558",
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "WA",
            "license": "MD00014558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7099864",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.