Individual provider Active NPI

A. Thomas Collins, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Bellevue, WA
National Provider Identifier
1699784561
Registry record updated Nov 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
14695 Issued in WA
Practice address
1600 116TH Ave NE
Suite #302
Bellevue, WA 98004-3014
Phone
(425) 455-5440
Fax
(425) 455-1431
NPI assigned
Aug 7, 2006
Last updated
Nov 8, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 8, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 14695 WA
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 14695 WA Primary

Addresses

Primary practice location

1600 116TH Ave NE
Suite #302
Bellevue, WA 98004-3014

Mailing address

1600 116TH Ave NE
Suite #302
Bellevue, WA 98004-3014
Phone (425) 455-5440

Other identifiers 1

IdentifierTypeStateIssuer
1471200MedicaidWA

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

State licenses

LicenseStateTypeSpecialty
025209WAMDFamily Medicine Physician
14695WAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital & Regional Medical Center 2 Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352332800000",
    "number": "1699784561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 116TH AVE NE",
            "address_2": "SUITE #302",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043014",
            "telephone_number": "425-455-5440",
            "fax_number": "425-455-1431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 116TH AVE NE",
            "address_2": "SUITE #302",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043014",
            "telephone_number": "425-455-5440",
            "fax_number": "425-455-1431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "A.",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2012-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WA",
            "license": "14695",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "WA",
            "license": "14695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1471200",
            "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 Nov 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.