Bellevue Medical Center

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA10004437 Issued in WA

Legal business name

BELLEVUE MEDICAL CENTER

Practice address

10655 NE 4TH St
Ste 101
Bellevue, WA 98004-5035

Phone

(425) 577-1517

Fax

(425) 454-7767

NPI assigned

Nov 11, 2015

Last updated

Nov 11, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Raymon KoonerNPI 1053404038

Title

President

Phone

(425) 577-1517

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 15

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.

• Patrick Douglas Gorrell, DC

  • Chiropractor
  • Burien, WA
  • NPI 1457864969
  Medicare reassignment Care Compare group NPD
• Raymon Kooner, DC

  • Chiropractor
  • Bellevue, WA
  • NPI 1053404038
  Medicare reassignment Authorized official
• Michael Frank Schultz, DC

  • Chiropractor
  • Camas, WA
  • NPI 1285925172
  Medicare reassignment Care Compare group
• Michael Keith Bastron, D.C.

  • Chiropractor
  • Federal Way, WA
  • NPI 1023030962
  Medicare reassignment
• Nicholaus Allen Martin, DC

  • Chiropractor
  • Olympia, WA
  • NPI 1194497685
  Medicare reassignment
• Gina M. Mower, PA-C

  • Physician Assistant
  • Seattle, WA
  • NPI 1104037514
  Medicare reassignment
• Guan Wang

  • Chiropractor
  • Bellevue, WA
  • NPI 1962353144
  Medicare reassignment
• Bryce Lee Bisching, D.C.

  • Chiropractor
  • Gilbert, AZ
  • NPI 1548658974

  WA

  Medicare reassignment
• Yoomi Oh, PA

  • Primary Care Nurse Practitioner
  • San Antonio, TX
  • NPI 1174933808

  WA

  Medicare reassignment
• Corneliu Volosen, ARNP

  • Nurse Practitioner
  • Beaverton, OR
  • NPI 1033738455

  WA

  Medicare reassignment
• Daniel Leonard Jones, LMP

  • Specialist
  • Kirkland, WA
  • NPI 1316284771
  NPD (past)
• Matthew Kill, D.C

  • Chiropractor
  • Kirkland, WA
  • NPI 1326412560
  NPD (past)

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

{
    "created_epoch": "1447200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447200000000",
    "number": "1750754883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10655 NE 4TH ST",
            "address_2": "STE 101",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980045035",
            "telephone_number": "425-577-1517",
            "fax_number": "425-454-7767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10655 NE 4TH ST",
            "address_2": "STE 101",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980045035",
            "telephone_number": "425-577-1517",
            "fax_number": "425-454-7767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BELLEVUE MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-11",
        "last_updated": "2015-11-11",
        "status": "A",
        "authorized_official_last_name": "KOONER",
        "authorized_official_first_name": "RAYMON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-577-1517"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10004437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bellevue Interventional Spine Specialist PS (Bellevue Spine Specialist)
• Bellevue Interventional Spine Specialist PS (Bellevue Spine Specialist)
• Bellevue Kidney Specialists PLLC
• Bellevue Laser and Cosmetic Center PS
• Bellevue Legacy Primary Care PLLC
• Bellevue Medical Imaging, PLLC
• Bellevue Neurology and Neuroscience PLLC
• Bellevue Neuromuscular Dentistry LLC
• Bellevue OBGYN LLC
• Bellevue Optometry Clinic PS (Bellevue Optometry Clinic)

• Physician Assistant in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.