Individual provider Active NPI

Maricel Hinkulow, ARNP

  • Gerontology Nurse Practitioner
  • Renton, WA
National Provider Identifier
1659702058
Registry record updated Apr 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AP60428735 Issued in WA
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

Updated by the provider on Apr 18, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2035601MedicaidWA

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
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 IncGroup PAC ID 4082868815, 750 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

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

LicenseStateTypeSpecialty
AP60428735WAMDGerontology 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.

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

Verify at the official NPI Registry.