Individual provider Active NPI

Kristen M Wells, MD

  • Surgery Physician
  • Seattle, WA
National Provider Identifier
1780642397
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD61564114 Issued in WA
Practice address
1100 9TH Ave
Seattle, WA 98101-2756
Phone
(206) 341-0060
NPI assigned
May 3, 2006
Last updated
Nov 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 44601-020 WI
Surgery Physician 208600000X MD61564114 WA Primary

Addresses

Primary practice location

1100 9TH Ave
Seattle, WA 98101-2756

Mailing address

PO Box 741515
Los Angeles, CA 90074-1515
Phone (206) 515-5811

Other practice location 1

16233 Sylvester Rd SW Ste 110
Burien, WA 98166-3044
Phone (206) 901-8980

Other identifiers 2

IdentifierTypeStateIssuer
1780642397MedicaidWI
2292156MedicaidWA

Other names 1

  • Kristy Wells Professional name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kwells259059@direct-ehr-ssmhc.com Direct
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20051222000310 WI Practitioner - General Surgery 0840212585 Reassigns benefits to 2 organizations
I20240730003410 WA Practitioner - General Surgery 0840212585 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virginia Mason Medical CenterGroup PAC ID 9830002617, 867 clinicians

Practice addresses (Care Compare)

1100 Olive Way
Suite 531
Seattle, WA 98101-1873
Phone (206) 223-6762

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD61564114WAMDSurgery Physician
44601-020WIMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group Surgery CurrentSince Sep 1, 2024 Accepting new patients
Virginia Mason Medical Center Surgery CurrentSince Aug 29, 2024 Accepting new patients
Mercy Health System Corporation CurrentSince Sep 18, 2014 Accepting new patients
Langlade Hospital - Hotel Dieu of St. Joseph of Antigo Wisconsin CurrentSince Aug 1, 2016 Accepting new patients
Aspirus Medical Group, Inc. CurrentSince Aug 1, 2016 Accepting new patients
Mercy Health System Corporation CurrentSince Sep 18, 2014 Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Surgery CurrentSince Aug 29, 2024 Accepting new patients
Langlade Hospital - Hotel Dieu of St Joseph of Antigo Wisconsin Current Accepting new patients
Prairie Ridge Health, Inc. Surgery Past Accepting new patients
Franciscan Medical Group Past Accepting new patients
Virginia Mason Medical Center Past Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

29980 Network Pl
Chicago, IL 60673

380 Winslow Way E
Bainbridge Island, WA 98110
Phone (206) 842-5632

16233 Sylvester Rd SW
Ste 110
Burien, WA 98166
Phone (206) 439-5577

16259 Sylvester Rd SW
Ste 401
Burien, WA 98166
Phone (206) 242-8837

34503 9th Ave S
Ste 130
Federal Way, WA 98003
Phone (253) 835-5340

1100 9th Ave
Seattle, WA 98101
Phone (206) 223-6980

1100 9th Ave
#C6
Seattle, WA 98101
Phone (206) 341-0060

1100 Olive Way
Ste 531
Seattle, WA 98101
Phone (206) 223-6762

4575 Sand Point Way NE
Ste 108
Seattle, WA 98105
Phone (206) 525-8000

925 Seneca St
Seattle, WA 98101
Phone (206) 341-0860

110 E 5th Ave
Antigo, WI 54409
Phone (715) 623-2351

112 E 5th Ave
Antigo, WI 54409
Phone (715) 623-2331

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

900 Ridge St
Stoughton, WI 53589
Phone (608) 231-3410

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/a87187e5-fe2f-447e-bf32-4eeb3954a735/

Organizations & group practices 13

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.

View all 13

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1780642397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741515",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900741515",
            "telephone_number": "206-515-5811"
        },
        {
            "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": "206-341-0060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16233 Sylvester Rd SW Ste 110",
            "address_purpose": "LOCATION",
            "city": "Burien",
            "state": "WA",
            "postal_code": "981663044",
            "country_code": "US",
            "telephone_number": "206-901-8980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELLS",
        "first_name": "KRISTEN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "44601-020",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD61564114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780642397",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2292156",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kwells259059@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "kwells259059@direct-ehr-ssmhc.com",
            "address_1": "1626 Tuttle St",
            "city": "Baraboo",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539131501",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "1626 Tuttle St",
            "city": "Baraboo",
            "state": "WI",
            "country_code": "US",
            "postal_code": "539131501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KRISTY",
            "last_name": "WELLS",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.