Individual provider Active NPI

Bruce A. Webster, MD

  • Emergency Medicine Physician
  • Seattle, WA
National Provider Identifier
1770549008
Registry record updated Apr 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD00038445 Issued in WA
Practice address
747 Broadway
Seattle, WA 98122-4379
Phone
(206) 386-6000
NPI assigned
Apr 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X MD00038445 WA
Emergency Medicine Physician 207P00000X MD00038445 WA Primary

Addresses

Primary practice location

747 Broadway
Seattle, WA 98122-4379

Mailing address

6735 36TH Ave SW
Seattle, WA 98126-3013

Other identifiers 1

IdentifierTypeStateIssuer
8264590MedicaidWA

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
I20100322000796 WA Practitioner - Emergency Medicine 5193850600 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services- Washington CurrentSince Oct 1, 2021 Accepting new patients
Providence Health & Services- Washington CurrentSince Oct 1, 2021 Accepting new patients
Providence Health & Services - Washington Past Accepting new patients
Proliance Surgeons Inc P S PastSince Apr 15, 2000 Accepting new patients

Locations

2205 Broadway
Everett, WA 98201
Phone (425) 252-5213

718 91st Ave NE
Lake Stevens, WA 98258
Phone (425) 334-1523

4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

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.

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272499200000",
    "number": "1770549008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6735 36TH AVE SW",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981263013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 BROADWAY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981224379",
            "telephone_number": "206-386-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBSTER",
        "first_name": "BRUCE",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2010-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "WA",
            "license": "MD00038445",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD00038445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8264590",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.