Individual provider Active NPI

Ryu Komatsu, M.D.

  • Anesthesiology Physician
  • Seattle, WA
National Provider Identifier
1730316175
Registry record updated Sep 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD60832703 Issued in WA
Practice address
1959 NE Pacific St
Seattle, WA 98195
Phone
(206) 520-5000
NPI assigned
Jun 12, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD60832703 WA Primary

Addresses

Primary practice location

1959 NE Pacific St
Seattle, WA 98195

Mailing address

PO Box 50095
Seattle, WA 98145-5095
Phone (206) 520-5700

Other identifiers 1

IdentifierTypeStateIssuer
1730316175MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150624002921 CA Practitioner - Anesthesiology 6507177086
I20211214001856 OH Practitioner - Pain Management 6507177086 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pain Management
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-6116

Hospital & facility affiliations

  • Cleveland Clinic Hospital, Cleveland, OH, CCN 360180

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Cleveland Clinic Foundation CurrentSince Dec 1, 2021 Accepting new patients

Locations

300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

6801 Brecksville Rd
Ste 20
Seven Hills, OH 44131
Phone (216) 445-3363

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 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": "1244764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536278400000",
    "number": "1730316175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095",
            "telephone_number": "206-520-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98195",
            "telephone_number": "206-520-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMATSU",
        "first_name": "RYU",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-12",
        "last_updated": "2018-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "MD60832703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730316175",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.