NPIMap

Organization Active NPI

Puget Sound Neurology

  • Specialist
  • Edmonds, WA
National Provider Identifier
1740273366
Registry record updated Dec 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PUGET SOUND NEUROLOGY
Practice address
7320 216TH St SW
Ste 310
Edmonds, WA 98026-8006
Phone
(425) 673-3800
Fax
(425) 673-3802
NPI assigned
Aug 30, 2005
Last updated
Dec 23, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2014

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

Authorized official

Name
Ellen M Modell, MDNPI 1962437491
Title
Neurologist
Phone
(425) 673-3800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU Primary

Addresses

Primary practice location

7320 216TH St SW
Ste 310
Edmonds, WA 98026-8006

Mailing address

7320 216TH St SW
Suite 310
Edmonds, WA 98026-8006
Phone (425) 673-3800

Other identifiers 2

IdentifierTypeStateIssuer
CG9954OtherWARR MEDICARE
7087844MedicaidWA

National Provider Directory

National Provider Directory

Locations

21701 76th Ave W
Ste 302
Edmonds, WA 98026
Phone (425) 502-5427

7320 216th St SW
Ste 310
Edmonds, WA 98026
Phone (425) 673-3800

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419292800000",
    "number": "1740273366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7320 216TH ST SW",
            "address_2": "SUITE 310",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980268006",
            "telephone_number": "425-673-3800",
            "fax_number": "425-672-3803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7320 216TH ST SW",
            "address_2": "STE 310",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980268006",
            "telephone_number": "425-673-3800",
            "fax_number": "425-673-3802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUGET SOUND NEUROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-30",
        "last_updated": "2014-12-23",
        "status": "A",
        "authorized_official_last_name": "MODELL",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "NEUROLOGIST",
        "authorized_official_telephone_number": "425-673-3800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CG9954",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7087844",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2014; 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.