Individual provider Active NPI

Emily Rose Bainwol, MD

  • Family Medicine Physician
  • Seattle, WA
National Provider Identifier
1770066979
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD61070326 Issued in WA
Practice address
510 Boren Ave N
Seattle, WA 98109-5501
Phone
(206) 320-5200
Fax
(206) 320-5202
NPI assigned
Sep 13, 2018
Last updated
Jul 25, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD61070326 WA Primary

Addresses

Primary practice location

510 Boren Ave N
Seattle, WA 98109-5501

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220427002367 WA Practitioner - Family Practice 0143572677 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Swedish Health ServicesGroup PAC ID 9537072814, 384 clinicians

Practice addresses (Care Compare)

510 Boren Ave N
Seattle, WA 98109-5501
Phone (206) 320-5200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD61070326WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Health Services Family Medicine CurrentSince May 9, 2022 Accepting new patients
Swedish Health Services CurrentSince May 9, 2022 Accepting new patients
Swedish Health Services Family Medicine Current Accepting new patients

Locations

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

2450 33rd Ave W
Ste 100
Seattle, WA 98199
Phone (206) 320-3364

510 Boren Ave N
Seattle, WA 98109
Phone (206) 320-5200

5350 Tallman Ave NW
Ste 301
Seattle, WA 98107
Phone (206) 320-3335

800 5th Ave
Ste 800
Seattle, WA 98104
Phone (206) 533-2944

Organizations & group practices 3

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.

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": "1536796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1770066979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 BOREN AVE N",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981095501",
            "telephone_number": "206-320-5200",
            "fax_number": "206-320-5202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAINWOL",
        "first_name": "EMILY ROSE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-13",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61070326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.