Individual provider Active NPI

Marlene Peng, MD

  • Allergy Physician
  • Seattle, WA
National Provider Identifier
1770697112
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
MD60102678 Issued in WA
Practice address
515 Minor Ave
3Rd Floor
Seattle, WA 98104-2120
Phone
(206) 386-9500
Fax
(206) 576-3802
NPI assigned
Aug 19, 2006
Last updated
Jun 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X MD60102678 WA Primary
Allergy & Immunology Physician 207K00000X 68453341205 UT
Pediatric Allergy/Immunology Physician 2080P0201X 46653 WI

Addresses

Primary practice location

515 Minor Ave
3Rd Floor
Seattle, WA 98104-2120

Mailing address

515 Minor Ave
Seattle, WA 98104-2120
Phone (206) 386-9500

Other identifiers 4

IdentifierTypeStateIssuer
256768OtherWALNI
8560427MedicaidWA
0024PEOtherWAREGENCE
34622400MedicaidWI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mpeng1042918@wm.providencedirect.org Direct

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
I20091201000115 WA Practitioner - Allergy/ImmunologyPractitioner - Pediatric Medicine 9638231707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Pediatric Medicine
Education
Northwestern University Feinberg Medical School, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Swedish Health ServicesGroup PAC ID 0244138196, 1,038 clinicians

Practice addresses (Care Compare)

1200 112TH Ave NE
Suite B250
Bellevue, WA 98004-3749
Phone 4253941650425394

747 Broadway
Seattle, WA 98122-4379
Phone (206) 386-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.1 of 100Reported as group
Quality
84.53
Promoting interoperability
100
Improvement activities
40
Cost
72.46

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
68453341205UTMDAllergy & Immunology Physician
46653WIMDPediatric Allergy/Immunology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Swedish Health Services CurrentSince Apr 4, 2016 Accepting new patients
Swedish Health Services Past Accepting new patients
Swedish Medical Center-Radia Issaquah Imaging Center LLC Past Accepting new patients

Locations

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

515 Minor Ave
Ste 210
Seattle, WA 98104
Phone (206) 340-1800

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

800 5th Ave
Ste 600
Seattle, WA 98104

Interoperability endpoints

  • Direct secure messaging: mpeng1042918@wm.providencedirect.org

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 1

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1770697112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 MINOR AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042120",
            "telephone_number": "206-386-9500",
            "fax_number": "206-576-3802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 MINOR AVE",
            "address_2": "3RD FLOOR",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042120",
            "telephone_number": "206-386-9500",
            "fax_number": "206-576-3802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENG",
        "first_name": "MARLENE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "WA",
            "license": "MD60102678",
            "primary": true
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "UT",
            "license": "68453341205",
            "primary": false
        },
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "WI",
            "license": "46653",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LNI",
            "identifier": "256768",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8560427",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "0024PE",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34622400",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpeng1042918@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "515 Minor Ave",
            "address_2": "3rd Floor",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981042120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.