Individual provider Active NPI

Apollo Kanyonyi Kabukuru, MD

  • Family Medicine Physician
  • Seattle, WA
National Provider Identifier
1801474440
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD61525192 Issued in WA
Practice address
515 Minor Ave Ste 205
Seattle, WA 98104-2113
Phone
(206) 470-1800
NPI assigned
Apr 1, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD61525192 WA Primary

Addresses

Primary practice location

515 Minor Ave Ste 205
Seattle, WA 98104-2113

Mailing address

1201 2ND Ave Ste 1400
Seattle, WA 98101-3039
Phone (206) 395-7870

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
I20210825002255 WA Order and Referring Only - Family PracticePractitioner - Family Practice 1759786072

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vera Whole Health Wa PC CurrentSince Aug 11, 2024 Accepting new patients
Vera Whole Health Wa PC PastSince Aug 11, 2024 Accepting new patients

Locations

1201 2nd Ave
Ste 1400
Seattle, WA 98101

515 Minor Ave
Ste 205
Seattle, WA 98104
Phone (206) 470-1800

Interoperability endpoints

  • Direct secure messaging: akabukuru3900699@ghc.direct-ci.net
  • Direct secure messaging: apollo.kabukuru.1@32512.direct.athenahealth.com

Organizations & group practices 2

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": "1617235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1801474440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 2ND AVE STE 1400",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981013039",
            "telephone_number": "206-395-7870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 MINOR AVE STE 205",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042113",
            "telephone_number": "206-470-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KABUKURU",
        "first_name": "APOLLO",
        "middle_name": "KANYONYI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-01",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61525192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.