Individual provider Active NPI

Laura E Polito, M.D.

  • Family Medicine Physician
  • Seattle, WA
National Provider Identifier
1629173778
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD61356973 Issued in WA
Practice address
4915 25TH Ave NE Ste 300W
Seattle, WA 98105-5668
Phone
(206) 520-5000
NPI assigned
Sep 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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 MD61356973 WA Primary

Addresses

Primary practice location

4915 25TH Ave NE Ste 300W
Seattle, WA 98105-5668

Mailing address

PO Box 50095
Seattle, WA 98145-5095
Phone (206) 520-5700

Other identifiers 1

IdentifierTypeStateIssuer
1629173778MedicaidWA

Other names 1

  • Laura E Rader Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040330001738 CA Practitioner - Family Practice 0749272912 Reassigns benefits to 1 organization
I20230124002837 WA Practitioner - Family Practice 0749272912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Creighton University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Association of University PhysiciansGroup PAC ID 0446162697, 3,484 clinicians

Practice addresses (Care Compare)

32018 23Rd Ave S
Federal Way, WA 98003-6022
Phone (253) 839-3030

4915 25TH Ave NE 300
Uwnc Ravenna Clinic
Seattle, WA 98105-5668
Phone (206) 525-7777

620 Kirkland Way
Suite 206
Kirkland, WA 98033-6021
Phone (425) 845-5500

728 Edmonds Way
Rosewood Courte Memory Care
Edmonds, WA 98020-5126
Phone (425) 673-2875

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD61356973WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sansum Clinic CurrentSince Jan 5, 2004 Accepting new patients
Sansum Clinic CurrentSince Jan 5, 2004 Accepting new patients
Sansum Clinic Current Accepting new patients
The Association of University Physicians Family Medicine CurrentSince Jan 9, 2023 Accepting new patients

Locations

215 Pesetas Ln
Santa Barbara, CA 93110
Phone (805) 681-1765

168 N Brent St
Ste 503
Ventura, CA 93003
Phone (805) 653-0101

4915 25th Ave NE
Ste 300W
Seattle, WA 98105
Phone (206) 520-1606

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

Organizations & group practices 4

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1629173778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095",
            "telephone_number": "206-520-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4915 25TH AVE NE STE 300W",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981055668",
            "telephone_number": "206-520-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLITO",
        "first_name": "LAURA",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61356973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629173778",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "RADER",
            "middle_name": "E",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.