Individual provider Active NPI

Ross M Klein, PAC

  • Physician Assistant
  • Seattle, WA
National Provider Identifier
1760551931
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10003698 Issued in WA
Practice address
1100 9TH Ave
Seattle, WA 98101-2756
Phone
(206) 583-6450
NPI assigned
Nov 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10003698 WA Primary

Addresses

Primary practice location

1100 9TH Ave
Seattle, WA 98101-2756

Mailing address

9767 SE 41St St
Mercer Island, WA 98040
Phone (206) 326-3236

Other identifiers 4

IdentifierTypeStateIssuer
3103KLOtherWABLUE SHIELD #
US0872020OtherWAAETNA SPECIALIST PIN
0039578OtherWALABOR AND INDUSTRIES #
8369894MedicaidWA

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
I20070816000135 WA Practitioner - Physician Assistant 4688766975 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Overlake Medical Clinics LLCGroup PAC ID 7012808827, 423 clinicians

Practice addresses (Care Compare)

1035 116TH Ave NE
Bellevue, WA 98004-4604
Phone (425) 688-5072

17209 Redmond Way
Redmond, WA 98052-4404
Phone (425) 635-6400

1750 112TH Ave NE
Suite B102
Bellevue, WA 98004-3772
Phone (425) 688-5460

5708 E Lake Samm Pkwy SE
Issaquah, WA 98029-8942
Phone (425) 688-5488

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.26 of 100Reported as group
Quality
95.59
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
86.73 of 100Reported as apm
Quality
73.46
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Overlake Medical Clinics, LLC CurrentSince Feb 1, 2008 Accepting new patients
Radia Inc P S Past Accepting new patients
Issaquah Obstetrics and Gynecology PLLC Past Accepting new patients

Locations

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

10223 NE 10th St
Bellevue, WA 98004
Phone (425) 453-3288

1750 112th Ave NE
Ste B102
Bellevue, WA 98004
Phone (425) 688-5460

5708 E Lake Sammamish Pkwy SE
Ste 102
Issaquah, WA 98029
Phone (425) 688-5488

13159 Newcastle Commons Dr
Newcastle, WA 98059
Phone (425) 635-3010

17209 Redmond Way
Redmond, WA 98052
Phone (425) 635-6400

Organizations & group practices 5

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 2

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": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760551931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9767 SE 41ST ST",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "98040",
            "telephone_number": "206-326-3236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 9TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012756",
            "telephone_number": "206-583-6450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEIN",
        "first_name": "ROSS",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10003698",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD #",
            "identifier": "3103KL",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA SPECIALIST PIN",
            "identifier": "US0872020",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES #",
            "identifier": "0039578",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8369894",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.