Individual provider Active NPI

Shirley Penkar, MD

  • Obstetrics & Gynecology Physician
  • Kirkland, WA
National Provider Identifier
1790944486
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
61366593 Issued in WA
Practice address
12303 NE 130TH LN
Ste Coral 420
Kirkland, WA 98034
Phone
(425) 899-6400
Fax
(450) 899-4033
NPI assigned
Jun 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X P2913 TX
Obstetrics & Gynecology Physician 207V00000X 61366593 WA Primary

Addresses

Primary practice location

12303 NE 130TH LN
Ste Coral 420
Kirkland, WA 98034

Mailing address

12303 NE 130TH LN Ste Coral 1420
Kirkland, WA 98034
Phone (425) 899-6400

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
I20221209002188 WA Practitioner - Obstetrics/Gynecology 3173789526 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Texas Southwestern Medical School at Dallas, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
King County Public Hospital District No 2Group PAC ID 7618880097, 586 clinicians

Practice addresses (Care Compare)

12303 NE 130TH LN
Suite 450
Kirkland, WA 98034-3032
Phone (425) 899-6400

Merit-based Incentive Payment System (MIPS)

Final score
86.73 of 100Reported as apm
Quality
73.46
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61366593WAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No 2 Current Accepting new patients
King County Public Hospital District No 2 CurrentSince Dec 1, 2022 Accepting new patients
King County Public Hospital District No. 2 CurrentSince Dec 1, 2022 Accepting new patients
King County Public Hospital District No 2 Past Accepting new patients
King County Public Hospital District No 2 Past Accepting new patients
King County Public Hospital District No. 2 Past Accepting new patients

Locations

12303 NE 130th Ln
Ste 420
Kirkland, WA 98034
Phone (425) 899-6400

12040 NE 128th St
#50
Kirkland, WA 98034
Phone (425) 899-1894

12303 NE 130th Ln
Ste 450
Kirkland, WA 98034
Phone (425) 899-5000

Interoperability endpoints

  • Direct secure messaging: spenkar26758@directhoustonmethodist.org
  • Direct secure messaging: spenkar@direct.uspi.com

Organizations & group practices 6

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": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1790944486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12303 NE 130TH LN STE CORAL 1420",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "98034",
            "telephone_number": "425-899-6400",
            "fax_number": "450-899-4033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12303 NE 130TH LN",
            "address_2": "STE CORAL 420",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "98034",
            "telephone_number": "425-899-6400",
            "fax_number": "450-899-4033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENKAR",
        "first_name": "SHIRLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-06",
        "last_updated": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "P2913",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "61366593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.