Active NPI
John Y Peng, MD
- Internal Medicine Physician
- Lynnwood, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD00037612
- Practice address
- 19116 33Rd Ave W
Lynnwood, WA 98036-4706 - Phone
- (425) 771-7500
- Fax
- (425) 712-7903
- NPI assigned
- Aug 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD00037612 | WA | Primary |
Addresses
Primary practice location
19116 33Rd Ave W
Lynnwood, WA 98036-4706
Mailing address
1100 9TH Ave
Seattle, WA 98101-2756
Phone (206) 515-5811
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110207377 | Other | WA | RAILROAD MEDICARE |
| 0039581 | Other | WA | LABOR & INDUSTRY |
| 3328PE | Other | WA | BLUE SHIELD |
| US0818663 | Other | WA | AETNA/USHC SPECIALIST |
| 8254336 | 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: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Albany Medical College of Union University, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Select Outpatient Services Inc
Practice addresses (Care Compare)
19116 33Rd Ave W
Lynnwood, WA 98036-4706
Phone (425) 712-7900
2600 Compass Rd
Glenview, IL 60026-8001
Hospital & facility affiliations
- Evergreenhealth Home Care Services
- Centerwell Home Health
- Providence at Home With Compassus, Snohomish County
- Virginia Mason Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Virginia Mason Medical Center | Internal Medicine | Current | Accepting new patients |
| Virginia Mason Medical Center | Current | Accepting new patients | |
| Virginia Mason Medical Center | Current | Accepting new patients | |
| Virginia Mason Medical Center | Past | Accepting new patients |
Locations
380 Winslow Way E
Bainbridge Island, WA 98110
Phone (206) 842-5632
19116 33rd Ave W
Lynnwood, WA 98036
Phone (425) 712-7900
925 Seneca St
Seattle, WA 98101
Phone (206) 341-0860
1100 9th Ave
Seattle, WA 98101
Phone (206) 223-6980
4575 Sand Point Way NE
Ste 108
Seattle, WA 98105
Phone (206) 525-8000
Interoperability endpoints
- john.peng@direct.vmmc.org
- https://fhir-myrecord.cerner.com/r4/66ad9a50-d7f7-4c21-b933-2ba90047388e/
Organizations & group practices 5
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.
-
- General Acute Care Hospital
- Seattle, WA
- NPI 1801851258
-
- Rehabilitation Clinic/Center
- Glenview, IL
- NPI 1346368248
-
- Family Medicine Physician
- Bainbridge Island, WA
- NPI 1730237942
Internal Medicine
-
- Interventional Cardiology Physician
- Tacoma, WA
- NPI 1821711953
-
- Gastroenterology Physician
- Seattle, WA
- NPI 1003970989
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Everett, WA
- NPI 1538198817
-
- Home Health Agency
- Everett, WA
- NPI 1720800857
-
- Home Health Agency
- Kirkland, WA
- NPI 1588662761
-
- General Acute Care Hospital
- Seattle, WA
- NPI 1801851258
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155513600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359676800000",
"number": "1669485447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 9TH AVE",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981012756",
"telephone_number": "206-515-5811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19116 33RD AVE W",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980364706",
"telephone_number": "425-771-7500",
"fax_number": "425-712-7903"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENG",
"first_name": "JOHN",
"middle_name": "Y",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-14",
"last_updated": "2013-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WA",
"license": "MD00037612",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "110207377",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRY",
"identifier": "0039581",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "3328PE",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA/USHC SPECIALIST",
"identifier": "US0818663",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8254336",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lynnwood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2013; 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.