NPIMap

Organization Active NPI

Dr Grabowski PC

  • Foot & Ankle Surgery Podiatrist
  • Bellevue, WA
National Provider Identifier
1679761324
Registry record updated Jan 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO00000825 Issued in WA
Legal business name
DR GRABOWSKI PC
Practice address
11711 NE 12TH St
Suite 1B
Bellevue, WA 98005-2461
Phone
(425) 453-1598
Fax
(425) 450-0029
NPI assigned
Oct 9, 2007
Last updated
Jan 28, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2009

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

Authorized official

Name
Luz Emelia Lopez, DPMNPI 1588860621
Title
Vicepresident
Phone
(305) 389-0079

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X PO00000825 WA Primary

Addresses

Primary practice location

11711 NE 12TH St
Suite 1B
Bellevue, WA 98005-2461

Mailing address

11711 NE 12TH St
Suite 1B
Bellevue, WA 98005-2461
Phone (425) 453-1598

Other identifiers 3

IdentifierTypeStateIssuer
7139736MedicaidWA
756480615OtherWARAILROAD MEDICARE
0227706OtherWAL&I INSURANCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20071102000504 WA Part B Supplier - Clinic/Group Practice 0345337630 Receives reassigned benefits from 4 practitioners
2 other NPIs on this enrollment
Practice locations: Bellevue, WA; Issaquah, WA; Seattle, WA
O20100930042878 WA DME Supplier - Physician - Podiatry 0345337630 Practice locations: Bellevue, WA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Dr Grabowski PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233100800000",
    "number": "1679761324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11711 NE 12TH ST",
            "address_2": "SUITE 1B",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052461",
            "telephone_number": "425-453-1598",
            "fax_number": "425-450-0029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11711 NE 12TH ST",
            "address_2": "SUITE 1B",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980052461",
            "telephone_number": "425-453-1598",
            "fax_number": "425-450-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR GRABOWSKI PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-09",
        "last_updated": "2009-01-28",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "LUZ",
        "authorized_official_middle_name": "EMELIA",
        "authorized_official_title_or_position": "VICEPRESIDENT",
        "authorized_official_telephone_number": "305-389-0079",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WA",
            "license": "PO00000825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7139736",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "756480615",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I INSURANCE",
            "identifier": "0227706",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.