Individual provider Active NPI

Myra Horiuchi, M.D.

  • Family Medicine Physician
  • Edmonds, WA
National Provider Identifier
1649376237
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
00035077 Issued in WA
Practice address
7315 212TH St SW
Edmonds, WA 98026-7610
Phone
(425) 775-9474
NPI assigned
Sep 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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 00035077 WA Primary

Addresses

Primary practice location

7315 212TH St SW
Edmonds, WA 98026-7610

Mailing address

1145 Broadway FL 2
Seattle, WA 98122-4201
Phone (206) 860-5414

Other practice location 1

904 7th Ave
Seattle, WA 98104-1132
Phone (206) 329-1760

Other identifiers 1

IdentifierTypeStateIssuer
8227282MedicaidWA

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
I20100830000029 WA Practitioner - Family Practice 4880718741 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Albert Einstein College of Medicine of Yeshiva University, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians
The Polyclinic PLLCGroup PAC ID 2163328196, 364 clinicians

Practice addresses (Care Compare)

2600 Compass Rd
Glenview, IL 60026-8001

904 7TH Ave
Seattle, WA 98104-1132
Phone (206) 309-1760

Hospital & facility affiliations

  • Swedish Medical Center Hospital, Seattle, WA, CCN 500027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00035077WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Polyclinic PLLC Family Medicine Current Accepting new patients
The Polyclinic PLLC Family Medicine CurrentSince Jan 20, 2022 Accepting new patients
The Polyclinic PLLC Family Medicine Past Accepting new patients
Peninsula Cancer Center LLC PastSince Jan 26, 2022 Accepting new patients

Locations

7315 212th St SW
Ste 101
Edmonds, WA 98026
Phone (425) 670-3550

7315 212th St SW
Edmonds, WA 98026
Phone (425) 252-8375

1145 Broadway
Seattle, WA 98122

1145 Broadway
Fl 2
Seattle, WA 98122
Phone (206) 860-3509

904 7th Ave
Seattle, WA 98104
Phone (206) 223-6487

Interoperability endpoints

  • Direct secure messaging: mhoriuchi49100@direct.tecmc.com

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1649376237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 BROADWAY FL 2",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981224201",
            "telephone_number": "206-860-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7315 212TH ST SW",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267610",
            "telephone_number": "425-775-9474"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "904 7th Ave",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981041132",
            "country_code": "US",
            "telephone_number": "206-329-1760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HORIUCHI",
        "first_name": "MYRA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "00035077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8227282",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

Verify at the official NPI Registry.