NPIMap

Organization Active NPI

Puget Sound Physicians PLLC

  • Emergency Medicine Physician
  • Bellevue, WA
National Provider Identifier
1801900501
Registry record updated Sep 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
PUGET SOUND PHYSICIANS PLLC
Practice address
1035 116TH Avenue NE
Bellevue, WA 98004
Phone
(425) 688-5759
Fax
(425) 688-5101
NPI assigned
Aug 18, 2006
Last updated
Sep 15, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2014

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

Authorized official

Name
Shelli I Pereira
Title
Chief Financial Officer
Phone
(425) 688-5759

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary

Addresses

Primary practice location

1035 116TH Avenue NE
Bellevue, WA 98004

Mailing address

PO Box 34960
Seattle, WA 98124-1960
Phone (425) 688-5759

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040108000594 WA Part B Supplier - Clinic/Group Practice 2961301882 Receives reassigned benefits from 77 practitioners
Practice locations: Bellevue, WA; Lynnwood, WA

National Provider Directory

National Provider Directory

Locations

3011 196th St SW
Lynnwood, WA 98036
Phone (425) 688-5759

Practitioners & affiliated clinicians

Practitioners 98

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 98

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410739200000",
    "number": "1801900501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34960",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241960",
            "telephone_number": "425-688-5759",
            "fax_number": "425-688-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 116TH AVENUE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98004",
            "telephone_number": "425-688-5759",
            "fax_number": "425-688-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PUGET SOUND PHYSICIANS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2014-09-15",
        "status": "A",
        "authorized_official_last_name": "PEREIRA",
        "authorized_official_first_name": "SHELLI",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "425-688-5759"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.