NPIMap

Individual provider Active NPI

Scott T Bonvallet, M.D.

  • Sleep Medicine (Internal Medicine) Physician
  • Bellevue, WA
National Provider Identifier
1649230095
Registry record updated Jul 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X
License
MD00030620 Issued in WA
Practice address
1100 112TH Ave NE
Suite 320
Bellevue, WA 98004-4511
Phone
(425) 289-3000
Fax
(425) 289-3240
NPI assigned
Mar 27, 2006
Last updated
Jul 12, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X MD00030620 WA
Pulmonary Disease Physician 207RP1001X MD00030620 WA
Sleep Medicine (Internal Medicine) Physician 207RS0012X MD00030620 WA Primary

Addresses

Primary practice location

1100 112TH Ave NE
Suite 320
Bellevue, WA 98004-4511

Mailing address

PO Box 5845
Portland, OR 97228-5845
Phone (425) 454-5281

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100210000610 WA Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists)Practitioner - Sleep Medicine 9739080904 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Medical College of Wisconsin, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

311 S L St
Tacoma, WA 98405-3720

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

910 W 5TH Ave
Suite 1001
Spokane, WA 99204-2976
Phone (509) 755-6760

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Aug 11, 2023 Accepting new patients
Multicare Health System CurrentSince Aug 11, 2023 Accepting new patients
Multicare Health System Current Accepting new patients
Overlake Medical Clinics, LLC CurrentSince Apr 27, 2015 Accepting new patients
Overlake Medical Clinics LLC CurrentSince Apr 27, 2015 Accepting new patients
Multicare Health System Past Accepting new patients
Issaquah Obstetrics and Gynecology PLLC Past Accepting new patients
Multicare Health System Past Accepting new patients
Overlake Internal Medicine Laboratory PastSince Jul 25, 2019 Accepting new patients
Overlake Sleep Disorders Center Sleep Medicine PastSince Feb 1, 1997 Accepting new patients

Locations

1750 112th Ave NE
Ste B102
Bellevue, WA 98004
Phone (425) 688-5460

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

6520 226th Pl SE
Ste 150
Issaquah, WA 98027
Phone (425) 688-5777

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Organizations & group practices 10

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562889600000",
    "number": "1649230095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5845",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972285845",
            "telephone_number": "425-454-5281",
            "fax_number": "425-990-5261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 112TH AVE NE",
            "address_2": "SUITE 320",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044511",
            "telephone_number": "425-289-3000",
            "fax_number": "425-289-3240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONVALLET",
        "first_name": "SCOTT",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2019-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "WA",
            "license": "MD00030620",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WA",
            "license": "MD00030620",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "WA",
            "license": "MD00030620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.