Individual provider Active NPI

Roger Zundel, MD

  • Otolaryngology Physician
  • Bellevue, WA
National Provider Identifier
1689629651
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD00033644 Issued in WA
Practice address
1231 116TH Ave NE Ste 915
Bellevue, WA 98004-3822
Phone
(425) 454-3938
Fax
(425) 454-2568
NPI assigned
May 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD00033644 WA Primary

Addresses

Primary practice location

1231 116TH Ave NE Ste 915
Bellevue, WA 98004-3822

Mailing address

805 Madison Street
Suite 901
Seattle, WA 98104-1172
Phone (206) 264-8100

Other practice location 1

510 8th Ave NE Ste 310
Issaquah, WA 98029-5436
Phone (425) 454-3938

Other identifiers 1

IdentifierTypeStateIssuer
1016291MedicaidWA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080307000114 WA Practitioner - Otolaryngology 9133204795 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Utah School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proliance Surgeons Inc P SGroup PAC ID 8527972900, 395 clinicians

Practice addresses (Care Compare)

1231 116TH Ave NE
Suite 915
Bellevue, WA 98004-3822
Phone (425) 454-3938

Hospital & facility affiliations

  • Overlake Hospital Medical Center & Clinics Hospital, Bellevue, WA, CCN 500051
  • Swedish Issaquah Hospital, Issaquah, WA, CCN 500152

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00033644WAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons, Inc., P.S. CurrentSince Jun 1, 2008 Accepting new patients
Proliance Surgeons Inc P S CurrentSince Jun 1, 2008 Accepting new patients
Proliance Surgeons Inc P S Current Accepting new patients
Proliance Surgeons, Inc., P.S. Otolaryngology Past Accepting new patients

Locations

1135 116th Ave NE
Ste 500
Bellevue, WA 98004
Phone (425) 454-3938

1231 116th Ave NE
Ste 915
Bellevue, WA 98004
Phone (425) 454-3938

510 8th Ave NE
Ste 200
Issaquah, WA 98029
Phone (425) 392-3030

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

Interoperability endpoints

  • Direct secure messaging: roger.zundel.p79@direct.proliance.nextgenshare.com

Organizations & group practices 4

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 3

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1689629651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 MADISON STREET",
            "address_2": "SUITE 901",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041172",
            "telephone_number": "206-264-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 116TH AVE NE STE 915",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043822",
            "telephone_number": "425-454-3938",
            "fax_number": "425-454-2568"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 8th Ave NE Ste 310",
            "address_purpose": "LOCATION",
            "city": "Issaquah",
            "state": "WA",
            "postal_code": "980295436",
            "country_code": "US",
            "telephone_number": "425-454-3938",
            "fax_number": "425-392-3561",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZUNDEL",
        "first_name": "ROGER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WA",
            "license": "MD00033644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1016291",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.