Individual provider Active NPI

Dennis Jay Kvidera, MD

  • Orthopaedic Surgery Physician
  • Seattle, WA
National Provider Identifier
1639111040
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD00016053 Issued in WA
Practice address
515 Minor Ave
Ste 240
Seattle, WA 98104
Phone
(206) 386-9500
Fax
(206) 386-9538
NPI assigned
Jun 11, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD00016053 WA Primary

Addresses

Primary practice location

515 Minor Ave
Ste 240
Seattle, WA 98104

Mailing address

PO Box 3489
Seattle, WA 98114-3489
Phone (206) 386-9500

Other identifiers 1

IdentifierTypeStateIssuer
163145OtherWALABOR & INDUSTRY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Health Services Past Accepting new patients
Orthopedics International LTD. PS Orthopaedic Surgery Past Accepting new patients
Swedish Health Services Orthopaedic Surgery Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639111040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3489",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981143489",
            "telephone_number": "206-386-9500",
            "fax_number": "206-386-9538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 MINOR AVE",
            "address_2": "STE 240",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98104",
            "telephone_number": "206-386-9500",
            "fax_number": "206-386-9538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KVIDERA",
        "first_name": "DENNIS",
        "middle_name": "JAY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WA",
            "license": "MD00016053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRY",
            "identifier": "163145",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.