Active NPI
Maricel Hinkulow, ARNP
- Gerontology Nurse Practitioner
- Renton, WA
National Provider Identifier
1659702058
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- AP60428735
- Practice address
- 16224 SE 138TH PL
Renton, WA 98059-6837 - Phone
- (425) 970-5373
- Fax
- (425) 528-2546
- NPI assigned
- Dec 10, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | AP60428735 | WA | |
| Gerontology Nurse Practitioner | 363LG0600X | AP60428735 | WA | Primary |
Addresses
Primary practice location
16224 SE 138TH PL
Renton, WA 98059-6837
Mailing address
16224 SE 138TH PL
Renton, WA 98059-6837
Phone (425) 970-5373
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2035601 | Medicaid | WA |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140624000918 | WA | Practitioner - Nurse Practitioner | 0042434581 | Practice locations: Renton, WA |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Select Outpatient Services Inc
Practice addresses (Care Compare)
2600 Compass Rd
Glenview, IL 60026-8001
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP60428735 | WA | MD | Gerontology Nurse Practitioner |
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.
-
- Rehabilitation Clinic/Center
- Glenview, IL
- NPI 1346368248
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1460937600000",
"number": "1659702058",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16224 SE 138TH PL",
"city": "RENTON",
"state": "WA",
"postal_code": "980596837",
"telephone_number": "425-970-5373",
"fax_number": "425-528-2546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16224 SE 138TH PL",
"city": "RENTON",
"state": "WA",
"postal_code": "980596837",
"telephone_number": "425-970-5373",
"fax_number": "425-528-2546"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HINKULOW",
"first_name": "MARICEL",
"name_prefix": "Mrs.",
"credential": "ARNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-12-10",
"last_updated": "2016-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "WA",
"license": "AP60428735",
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "WA",
"license": "AP60428735",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2035601",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Renton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2016; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.