Active NPI
Kathleen Yanelli Moen, M.D.
- Orthopaedic Surgery Physician
- Seattle, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 10368
- Practice address
- 1101 Madison St
Suite 800
Seattle, WA 98104-1306 - Phone
- (206) 215-2700
- Fax
- (206) 215-2702
- NPI assigned
- Jun 23, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Orthopaedic Surgery Physician | 207XP3100X | MD60278954 | WA | |
| Orthopaedic Surgery Physician | 207X00000X | 10368 | NH | Primary |
Addresses
Primary practice location
1101 Madison St
Suite 800
Seattle, WA 98104-1306
Mailing address
1101 Madison St
Suite 800
Seattle, WA 98104-1306
Phone (206) 215-2700
Other practice location 1
751 NE Blakely Dr Ste 5010
Issaquah, WA 98029-6201
Phone (206) 215-2700
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30011560 | Medicaid | NH | |
| 0RE4880 | Medicaid | VT |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | kmoen1042558@wm.providencedirect.org | Direct | |
| Direct Messaging Address | kmoen1042558@wm.providencedirect.org | Direct |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Swedish Health Services | Orthopaedic Surgery | Current | Accepting new patients |
Locations
751 NE Blakely Dr
Ste 5010
Issaquah, WA 98029
Phone (425) 394-0700
800 5th Ave
Ste 600
Seattle, WA 98104
1101 Madison St
Ste 800
Seattle, WA 98104
747 Broadway
Seattle, WA 98122
Phone (360) 658-2488
Interoperability endpoints
- kmoen1042558@wm.providencedirect.org
Organizations & group practices 1
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": "1151020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621900800000",
"number": "1649206764",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1101 MADISON ST",
"address_2": "SUITE 800",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981041306",
"telephone_number": "206-215-2700",
"fax_number": "206-215-2702"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 MADISON ST",
"address_2": "SUITE 800",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981041306",
"telephone_number": "206-215-2700",
"fax_number": "206-215-2702"
}
],
"practiceLocations": [
{
"address_1": "751 NE Blakely Dr Ste 5010",
"address_purpose": "LOCATION",
"city": "Issaquah",
"state": "WA",
"postal_code": "980296201",
"country_code": "US",
"telephone_number": "206-215-2700",
"fax_number": "206-215-2702",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOEN",
"first_name": "KATHLEEN",
"middle_name": "YANELLI",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-23",
"last_updated": "2021-05-25",
"certification_date": "2021-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "207XP3100X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Pediatric Orthopaedic Surgery",
"state": "WA",
"license": "MD60278954",
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "NH",
"license": "10368",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30011560",
"state": "NH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0RE4880",
"state": "VT"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kmoen1042558@wm.providencedirect.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1101 Madison St",
"address_2": "suite 800",
"city": "Seattle",
"state": "WA",
"country_code": "US",
"postal_code": "981041306",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "kmoen1042558@wm.providencedirect.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "751 NE Blakely Dr Ste 5010",
"city": "Issaquah",
"state": "WA",
"country_code": "US",
"postal_code": "980296201",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 May 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.