Active NPI
Steven N Connelly, M.D.
- Emergency Medicine Physician
- Kirkland, WA
National Provider Identifier
1689629677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- MD00029817
- Practice address
- 12040 NE 128TH St
Kirkland, WA 98034-3013 - Phone
- (425) 899-1000
- NPI assigned
- May 24, 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | MD00029817 | WA | Primary |
Addresses
Primary practice location
12040 NE 128TH St
Kirkland, WA 98034-3013
Mailing address
File 50421
Los Angeles, CA 90074-0001
Phone (800) 793-3529
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8938302 | Other | WA CRIME VICTIM | |
| CO8227 | Other | REGENCE BS | |
| 184570 | Other | WA L&I | |
| 8148926 | Medicaid | WA | |
| E76665 | Other | GROUP HEALTH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
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": "1196640000000",
"number": "1689629677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "FILE 50421",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900740001",
"telephone_number": "800-793-3529"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12040 NE 128TH ST",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980343013",
"telephone_number": "425-899-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNELLY",
"first_name": "STEVEN",
"middle_name": "N",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-24",
"last_updated": "2007-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "WA",
"license": "MD00029817",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WA CRIME VICTIM",
"identifier": "8938302",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BS",
"identifier": "CO8227",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WA L&I",
"identifier": "184570",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8148926",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP HEALTH",
"identifier": "E76665",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Kirkland, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.