Individual provider Active NPI

Michelle Lynne Vierra, PA-C

  • Physician Assistant
  • Issaquah, WA
National Provider Identifier
1659451631
Registry record updated Aug 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10003847 Issued in WA
Practice address
Pickering Place
1455 11TH Ave NW
Issaquah, WA 98027
Phone
(425) 391-3900
NPI assigned
Oct 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10003847 WA Primary

Addresses

Primary practice location

Pickering Place
1455 11TH Ave NW
Issaquah, WA 98027

Mailing address

PO Box 50095
Seattle, WA 98145-5095
Phone (206) 543-6420

Other identifiers 2

IdentifierTypeStateIssuer
8356446MedicaidWA
253780OtherINTERNAL ID-MOTOR VEHICLE ID

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040720000117 WA Practitioner - Physician Assistant 0547249740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Association of University PhysiciansGroup PAC ID 0446162697, 3,484 clinicians

Practice addresses (Care Compare)

1701 Columbia Rd
Seattle, WA 98195-0001
Phone (206) 598-3100

1740 NW Maple St
Suite 100
Issaquah, WA 98027-8127
Phone (425) 391-3900

1959 NE Pacific St
Seattle, WA 98195-0001
Phone (206) 598-4333

3800 Montlake Blvd NE
Seattle, WA 98195-0007
Phone (206) 598-1534

4060 E Stevens Way
Hall Health Primary Care Ctr
Seattle, WA 98195-4410
Phone (206) 616-2495

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.85 of 100Reported as apm
Quality
74.6
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA10003847WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Association of University Physicians Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mvierra72379@direct.ehre.uwmedicine.org

Organizations & group practices 2

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346025600000",
    "number": "1659451631",
    "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": "206-543-6420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PICKERING PLACE",
            "address_2": "1455 11TH AVE NW",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "98027",
            "telephone_number": "425-391-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIERRA",
        "first_name": "MICHELLE",
        "middle_name": "LYNNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2012-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10003847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8356446",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERNAL ID-MOTOR VEHICLE ID",
            "identifier": "253780",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

Verify at the official NPI Registry.