Individual provider Active NPI

Ashley Megan Demaline

  • Gerontology Nurse Practitioner
  • Bellevue, WA
National Provider Identifier
1689976813
Registry record updated Jun 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AP60190843 Issued in WA
Practice address
11820 Northup Way
Suite E226
Bellevue, WA 98005-1946
Phone
(206) 552-6992
Fax
(206) 829-9660
NPI assigned
Nov 19, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X AP60190843 WA Primary

Addresses

Primary practice location

11820 Northup Way
Suite E226
Bellevue, WA 98005-1946

Mailing address

PO Box 557
Mercer Island, WA 98040-0557
Phone (206) 552-6992

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
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
I20240520001190 HI Practitioner - Nurse Practitioner 7416146907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

75-5995 Kuakini Hwy
Suite 213
Kailua Kona, HI 96740-2120
Phone (808) 638-3343

Hospital & facility affiliations

  • Kona Community Hospital Hospital, Kealakekua, HI, CCN 120019

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Koa Clinic, Inc CurrentSince Mar 3, 2024 Accepting new patients
Kirkland Primary Care Past Accepting new patients
Hewitt Patient Services Past Accepting new patients
Deichert Integrative Health LLC Past Accepting new patients

Locations

75-5995 Kuakini Hwy
Ste 445
Kailua Kona, HI 96740
Phone (808) 315-8466

75-5995 Kuakini Hwy
Ste 213
Kailua Kona, HI 96740
Phone (808) 365-2297

Interoperability endpoints

  • Direct secure messaging: ashley.demaline@233545743663108.direct.elationemr.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 1

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": "1290124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340668800000",
    "number": "1689976813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 557",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980400557",
            "telephone_number": "206-552-6992",
            "fax_number": "206-829-9660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11820 NORTHUP WAY",
            "address_2": "SUITE E226",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980051946",
            "telephone_number": "206-552-6992",
            "fax_number": "206-829-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMALINE",
        "first_name": "ASHLEY",
        "middle_name": "MEGAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-19",
        "last_updated": "2012-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WA",
            "license": "AP60190843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.