Individual provider Active NPI

Sanela Samardzic, PA-C

  • Surgical Physician Assistant
  • Kirkland, WA
National Provider Identifier
1730480153
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA60188654 Issued in WA
Practice address
12911 120TH Ave NE
Suite H-210
Kirkland, WA 98034-3027
Phone
(425) 823-4000
Fax
(425) 821-3550
NPI assigned
Nov 17, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA60188654 WA Primary
Physician Assistant 363A00000X PA60188654 WA

Addresses

Primary practice location

12911 120TH Ave NE
Suite H-210
Kirkland, WA 98034-3027

Mailing address

805 Madison St
Suite 901
Seattle, WA 98104-1172
Phone (206) 264-8100

Other practice location 1

1321 Colby Ave
Everett, WA 98201-1665
Phone (425) 261-2000

Other practice location 2

3726 Broadway Ste 201
Everett, WA 98201-3788
Phone (425) 317-9119

Other identifiers 3

IdentifierTypeStateIssuer
2011187MedicaidWA
G8959157OtherWAMEDICARE PTAN KING CO.
G8959158OtherWAMEDICARE PTAN

Other names 1

  • Mrs. Sanela Novakovic Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120312000243 WA Practitioner - Physician Assistant 4284893280 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

12033 NE 130TH LN
Suite 120
Kirkland, WA 98034-3052
Phone (425) 899-2160

12039 NE 128TH St
Kirkland, WA 98034-3029

12040 NE 128TH St
Kirkland, WA 98034-3013

12040 NE 128TH St Ms
Suite 55
Kirkland, WA 98034-3013

3726 Broadway
Suite 201
Everett, WA 98201-3788
Phone (425) 317-9119

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA60188654WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No. 2 CurrentSince Feb 1, 2022 Accepting new patients
DRX Wa Urgent Care Providers PLLC Physician Assistant CurrentSince Nov 16, 2015 Accepting new patients
Proliance Surgeons, Inc., P.S. CurrentSince Oct 31, 2016 Accepting new patients
Western Washington Medical Group, Inc PS CurrentSince Dec 5, 2025 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Dec 13, 2011 Accepting new patients
Proliance Surgeons Inc P S Surgical CurrentSince Oct 31, 2016 Accepting new patients
King County Public Hospital District No 2 CurrentSince Feb 1, 2022 Accepting new patients
Western Washington Medical Group, Inc PS CurrentSince Dec 5, 2025 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Dec 13, 2011 Accepting new patients

Locations

1909 214th St SE
Ste 110
Bothell, WA 98021
Phone (425) 488-4988

3726 Broadway
Ste 201
Everett, WA 98201
Phone (425) 317-9119

4225 Hoyt Ave
Ste A
Everett, WA 98203
Phone (425) 259-3122

1321 Colby Ave
Everett, WA 98201
Phone (425) 259-4413

12911 120th Ave NE
Ste H210
Kirkland, WA 98034
Phone (425) 823-4000

12039 NE 128th St
Ste 400
Kirkland, WA 98034
Phone (425) 899-4810

12911 120th Ave NE
Ste H120
Kirkland, WA 98034
Phone (425) 823-4226

12039 NE 128th St
Ste 300
Kirkland, WA 98034
Phone (425) 899-3123

12911 120th Ave NE
Ste G10
Kirkland, WA 98034
Phone (425) 481-6301

14841 179th Ave SE
Ste 330
Monroe, WA 98272
Phone (360) 794-3300

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

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

9000 Holman Rd NW
Ste A1
Seattle, WA 98117
Phone (206) 706-9001

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: ssamardzic2667@ghc.direct-ci.net
  • Direct secure messaging: ssamardzic922149@direct.multicare.org

Organizations & group practices 13

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 13

Hospital & facility affiliations 3

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": "1289952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1730480153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 MADISON ST",
            "address_2": "SUITE 901",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041172",
            "telephone_number": "206-264-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12911 120TH AVE NE",
            "address_2": "SUITE H-210",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343027",
            "telephone_number": "425-823-4000",
            "fax_number": "425-821-3550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1321 Colby Ave",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982011665",
            "country_code": "US",
            "telephone_number": "425-261-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3726 Broadway Ste 201",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "WA",
            "postal_code": "982013788",
            "country_code": "US",
            "telephone_number": "425-317-9119",
            "fax_number": "425-317-9118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAMARDZIC",
        "first_name": "SANELA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-17",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA60188654",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60188654",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2011187",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN KING CO.",
            "identifier": "G8959157",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "G8959158",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANELA",
            "last_name": "NOVAKOVIC",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.