Individual provider Active NPI

Haruna Dibba, PA-C

  • Surgical Physician Assistant
  • Kirkland, WA
National Provider Identifier
1710628631
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA70026449 Issued in WA
Practice address
11911 NE 132ND St Ste 200
Kirkland, WA 98034-2900
Phone
(425) 899-5800
NPI assigned
Apr 5, 2022
Last updated
Apr 14, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA70026449 WA Primary

Addresses

Primary practice location

11911 NE 132ND St Ste 200
Kirkland, WA 98034-2900

Mailing address

11911 NE 132ND St Ste 200
Kirkland, WA 98034-2900
Phone (425) 899-5800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220726001807 WI Practitioner - Physician Assistant 7416339205 Reassigns benefits to 6 organizations
I20251113004067 WA Practitioner - Physician Assistant 7416339205 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Wisconsin School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11911 NE 132ND St
Suite 200
Kirkland, WA 98034-2900
Phone (425) 899-5800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.6 of 100Reported as group
Quality
56.02
Promoting interoperability
100
Improvement activities
40
Cost
72.66

Merit-based Incentive Payment System (MIPS)

Final score
83.32 of 100Reported as group
Quality
87.78
Promoting interoperability
77
Improvement activities
40
Cost
75.8

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5812WIMDPhysical Therapist
PA70026449WAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Jul 25, 2022 Accepting new patients
MCHS Hospitals Inc CurrentSince Jul 25, 2022 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Jul 25, 2022 Accepting new patients
Memorial Hospital Inc CurrentSince Jul 25, 2022 Accepting new patients
King County Public Hospital District No. 2 CurrentSince Nov 1, 2025 Accepting new patients
King County Public Hospital District No 2 CurrentSince Nov 1, 2025 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Sep 11, 2023 Accepting new patients
MCHS Hospitals Inc CurrentSince Jul 25, 2022 Accepting new patients
University of Wisconsin Medical Foundation, Inc CurrentSince Sep 11, 2023 Accepting new patients
Flambeau Hospital Inc CurrentSince Jul 25, 2022 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Jul 25, 2022 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
Marshfield Clinic Inc CurrentSince Jul 25, 2022 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Jul 25, 2022 Accepting new patients

Locations

11911 NE 132nd St
Ste 200
Kirkland, WA 98034
Phone (425) 899-5800

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

707 S University Ave
Beaver Dam, WI 53916
Phone (920) 887-4006

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

7974 Uw Health Ct
Middleton, WI 53562
Phone (608) 829-5270

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Interoperability endpoints

  • Direct secure messaging: haruna.dibba@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 5

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": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1710628631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11911 NE 132ND ST STE 200",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980342900",
            "telephone_number": "425-899-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11911 NE 132ND ST STE 200",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980342900",
            "telephone_number": "425-899-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIBBA",
        "first_name": "HARUNA",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-05",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA70026449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.