NPIMap

Organization Active NPI

Pediatric Associates, Inc., P.S. Dba Allegro Pediatrics

  • Pediatrics Physician
  • Sammamish, WA
National Provider Identifier
1699849331
Registry record updated Oct 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATRIC ASSOCIATES, INC., P.S. DBA ALLEGRO PEDIATRICS
Practice address
22620 SE 4TH Street
Suite #200
Sammamish, WA 98074
Phone
(425) 836-5407
NPI assigned
Nov 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2020

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

Authorized official

Name
Brett Vandenberg
Title
Ceo
Phone
(425) 460-5643

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

22620 SE 4TH Street
Suite #200
Sammamish, WA 98074

Mailing address

2475 140TH Ave. NE, Building C
Bellevue, WA 98005
Phone (425) 460-5601

Other names 1

  • Sammamish Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D0957917Allegro Pediatrics22620 SE 4TH St # 200, Sammamish, WA 98074Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Associates Inc PS Dba Allegro Pediatrics9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3633 136th Pl SE
Ste 110
Bellevue, WA 98006
Phone (425) 747-7202

4122 Factoria Blvd SE
Ste 101
Bellevue, WA 98006
Phone (425) 643-0635

2475 140th Ave NE
Bellevue, WA 98005
Phone (253) 221-0634

805 164th St SE
Ste 100
Mill Creek, WA 98012
Phone (425) 354-4296

7530 164th Ave NE
Ste A215
Redmond, WA 98052
Phone (425) 885-9292

22635 NE Marketplace Dr
Redmond, WA 98053
Phone (425) 949-5961

22635 NE Marketplace Dr
Ste 12
Redmond, WA 98053

22603 NE Inglewood Hill Rd
Sammamish, WA 98074

22603 NE Inglewood Hill Rd
#100
Sammamish, WA 98074
Phone (425) 836-5407

22620 SE 4th St
Ste 200
Sammamish, WA 98074
Phone (425) 836-5407

Practitioners & affiliated clinicians

Practitioners 106

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 106

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602547200000",
    "number": "1699849331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2475 140TH AVE. NE, BUILDING C",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98005",
            "telephone_number": "425-460-5601",
            "fax_number": "425-460-5606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22620 SE 4TH STREET",
            "address_2": "SUITE #200",
            "city": "SAMMAMISH",
            "state": "WA",
            "postal_code": "98074",
            "telephone_number": "425-836-5407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ASSOCIATES, INC., P.S. DBA ALLEGRO PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2020-10-13",
        "certification_date": "2020-10-13",
        "status": "A",
        "authorized_official_last_name": "VANDENBERG",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "425-460-5643"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sammamish",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sammamish",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sammamish, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.