Individual provider Active NPI

Kathleen Kieran, MD

  • Urology Physician
  • Seattle, WA
National Provider Identifier
1801912134
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
38857 Issued in IA
Practice address
4800 Sand Point Way NE # Oa.9220
Seattle, WA 98105-3901
Phone
(206) 987-4403
Fax
(206) 987-3835
NPI assigned
Mar 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 25500 NE
Urology Physician 208800000X 38857 IA Primary

Addresses

Primary practice location

4800 Sand Point Way NE # Oa.9220
Seattle, WA 98105-3901

Mailing address

4800 Sand Point Way NE # Oa.9220
Seattle, WA 98105-3901
Phone (206) 987-4403

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
I20150512000252 WA Practitioner - UrologyPractitioner - Pediatric Medicine 0143365320 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
38857IAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Association of University Physicians Urology CurrentSince May 1, 2015 Accepting new patients
The Association of Chrmc and University Physicians CurrentSince Apr 15, 2015 Accepting new patients
Seattle Childrens Hospital CurrentSince Oct 31, 2015 Accepting new patients
Seattle Children'S Hospital Current Accepting new patients
Association of CHMC and University Physicians CurrentSince Apr 15, 2015 Accepting new patients
Seattle Children'S Hospital Past Accepting new patients
Seattle Children'S Hospital Past Accepting new patients

Locations

900 Pacific Ave
Ste 100
Everett, WA 98201
Phone (425) 304-6080

8232 W Grandridge Blvd
Kennewick, WA 99336
Phone (509) 582-1700

4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000

4800 Sand Point Way NE
#9220
Seattle, WA 98105
Phone (206) 987-3468

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

Interoperability endpoints

  • Direct secure messaging: kkieran17896@direct.seattlechildrens.org

Organizations & group practices 7

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": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1801912134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 SAND POINT WAY NE # OA.9220",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981053901",
            "telephone_number": "206-987-4403",
            "fax_number": "206-987-3835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 SAND POINT WAY NE # OA.9220",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981053901",
            "telephone_number": "206-987-4403",
            "fax_number": "206-987-3835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIERAN",
        "first_name": "KATHLEEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NE",
            "license": "25500",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "IA",
            "license": "38857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.