Creseta G Simmons, AGNP-C

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

AP60971067 Issued in WA

Practice address

11417 124TH Ave NE Ste 100
Kirkland, WA 98033-4677

Phone

(800) 640-3451

NPI assigned

May 31, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Specialty

Nurse Practitioner

Education

University of Washington School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Plaid Eagle Medical PLLCGroup PAC ID 6103268560, 35 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Plaid Eagle Medical PLLC

  • Family Medicine Physician
  • Monroeville, PA
  • NPI 1588417117

  WA

  Medicare reassignment Care Compare group NPD
• Seattle Roots Community Health

  • Federally Qualified Health Center (FQHC)
  • Seattle, WA
  • NPI 1972623189
  NPD
• United Wound Healing Accountable Care Consultants PLLC

  • Surgery Physician
  • Puyallup, WA
  • NPI 1881337632

  Gerontology

  NPD
• Public Hospital District No 4, King County Wa

  • Family Medicine Physician
  • Snoqualmie, WA
  • NPI 1144432634
  NPD (past)

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

{
    "created_epoch": "1559260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1780242131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1200",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840621200",
            "telephone_number": "800-640-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11417 124TH AVE NE STE 100",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980334677",
            "telephone_number": "800-640-3451"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 19th Ave E",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981124007",
            "country_code": "US",
            "telephone_number": "206-299-1600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "CRESETA",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "AGNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-31",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WA",
            "license": "AP60971067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "AP60971067",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "EPIC",
            "affiliation": "Y",
            "affiliationName": "Seattle Roots Community Health",
            "address_1": "500 19th Ave E",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981124007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mercy Dorothy Awuor Sigwe
• Stephen O Sills
• Rebeca Silva
• Cricia Silverberg
• Diana Sima, INTERPRETER
• Heidi Simmons
• Virginia I Simnad, M.D.
• Michael Simonson
• Simple Health Practical Solutions PC
• Shawna Simpson

• Gerontology Nurse Practitioner in Kirkland, WA
• Providers in Kirkland, WA by specialty
• Gerontology Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.