Individual provider Active NPI

Prashoban Bremjit, M.D.

  • Orthopaedic Surgery Physician
  • Renton, WA
National Provider Identifier
1699162289
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD61169415 Issued in WA
Practice address
4011 Talbot Rd S Ste 300
Renton, WA 98055-5791
Phone
(425) 656-5060
Fax
(425) 656-5047
NPI assigned
Apr 21, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X MD61169415 WA
Orthopaedic Surgery Physician 207X00000X MD61169415 WA Primary

Addresses

Primary practice location

4011 Talbot Rd S Ste 300
Renton, WA 98055-5791

Mailing address

4011 Talbot Rd S Ste 300
Renton, WA 98055-5791
Phone (425) 656-5060

Other practice location 1

150 Andover Park W
Tukwila, WA 98188-2801
Phone (425) 979-2663

Other practice location 2

27005 168th Pl SE Ste 201
Covington, WA 98042-4902
Phone (253) 630-3660

Other practice location 3

24060 SE Kent Kangley Rd Ste D-100
Maple Valley, WA 98038-6851
Phone (425) 358-7708

Other practice location 4

1620 Lake Tapps Pkwy SE Ste 115
Auburn, WA 98092-8376
Phone (253) 246-2860

Other practice location 5

515 Minor Ave Ste 200
Seattle, WA 98104-2133
Phone (425) 656-5060

Other identifiers 1

IdentifierTypeStateIssuer
2046162MedicaidWA

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
I20211006002844 WA Practitioner - Orthopedic Surgery 8123321288 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Washington School of Medicine, 2015
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)

4011 Talbot Rd S
Suite 300
Renton, WA 98055-5791
Phone (206) 656-5060

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement55
Knee replacement97
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons, Inc., P.S. Orthopaedic Surgery CurrentSince Sep 11, 2023 Accepting new patients
Proliance Surgeons Inc P S Orthopaedic Surgery Current Accepting new patients
Proliance Surgeons Inc P S Orthopaedic Surgery CurrentSince Sep 11, 2023 Accepting new patients
Proliance Surgeons, Inc., P.S. Past Accepting new patients

Locations

1620 Lake Tapps Pkwy SE
Ste 115
Auburn, WA 98092
Phone (253) 246-2860

27005 168th Pl SE
#201
Covington, WA 98042
Phone (253) 630-3660

24060 SE Kent Kangley Rd
#D100
Maple Valley, WA 98038
Phone (425) 358-7708

4011 Talbot Rd S
Ste 300
Renton, WA 98055
Phone (206) 656-5060

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

515 Minor Ave
Ste 200
Seattle, WA 98104
Phone (206) 386-9615

150 Andover Park W
Tukwila, WA 98188
Phone (425) 979-2663

Interoperability endpoints

  • Direct secure messaging: pbremjit111687@direct.valleymed.org

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 4

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": "1429574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1699162289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4011 TALBOT RD S STE 300",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555791",
            "telephone_number": "425-656-5060",
            "fax_number": "425-656-5047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 TALBOT RD S STE 300",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555791",
            "telephone_number": "425-656-5060",
            "fax_number": "425-656-5047"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "150 Andover Park W",
            "address_purpose": "LOCATION",
            "city": "Tukwila",
            "state": "WA",
            "postal_code": "981882801",
            "country_code": "US",
            "telephone_number": "425-979-2663",
            "fax_number": "425-524-4447",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "27005 168th Pl SE Ste 201",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "WA",
            "postal_code": "980424902",
            "country_code": "US",
            "telephone_number": "253-630-3660",
            "fax_number": "253-631-1591",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24060 SE Kent Kangley Rd Ste D-100",
            "address_purpose": "LOCATION",
            "city": "Maple Valley",
            "state": "WA",
            "postal_code": "980386851",
            "country_code": "US",
            "telephone_number": "425-358-7708",
            "fax_number": "425-656-5047",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1620 Lake Tapps Pkwy SE Ste 115",
            "address_purpose": "LOCATION",
            "city": "Auburn",
            "state": "WA",
            "postal_code": "980928376",
            "country_code": "US",
            "telephone_number": "253-246-2860",
            "fax_number": "253-246-2861",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "515 Minor Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981042133",
            "country_code": "US",
            "telephone_number": "425-656-5060",
            "fax_number": "425-656-5047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREMJIT",
        "first_name": "PRASHOBAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-21",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "WA",
            "license": "MD61169415",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WA",
            "license": "MD61169415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2046162",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.