Individual provider Active NPI

Meagan K Bouse, MD

  • Anesthesiology Physician
  • Kirkland, WA
National Provider Identifier
1811000201
Registry record updated Nov 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD 00047991 Issued in WA
Practice address
12040 NE 128TH St
Ms #69
Kirkland, WA 98034-3013
Phone
(425) 899-3455
NPI assigned
Aug 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD 00047991 WA Primary

Addresses

Primary practice location

12040 NE 128TH St
Ms #69
Kirkland, WA 98034-3013

Mailing address

12040 NE 128TH St
Ms #69
Kirkland, WA 98034-3013
Phone (425) 899-3455

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
I20070824000031 WA Practitioner - Anesthesiology 5496847253 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Matrix Anesthesia, PSGroup PAC ID 3971403700, 87 clinicians

Practice addresses (Care Compare)

1035 116TH Ave NE
Bellevue, WA 98004-4604
Phone (425) 688-5000

Hospital & facility affiliations

  • Evergreenhealth Medical Center Hospital, Kirkland, WA, CCN 500124
  • Evergreenhealth Monroe Hospital, Monroe, WA, CCN 500084

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD 00047991WAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Matrix Anesthesia, PS Anesthesiology CurrentSince Dec 1, 2008 Accepting new patients

Locations

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

1750 112th Ave NE
Ste D050
Bellevue, WA 98004
Phone (425) 296-3837

510 8th Ave NE
Ste 100
Issaquah, WA 98029
Phone (425) 507-0800

12040 NE 128th St
#69
Kirkland, WA 98034
Phone (206) 540-0175

12040 NE 128th St
Ste Blue
Kirkland, WA 98034

12040 NE 128th St
Kirkland, WA 98034
Phone (425) 899-1000

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385078400000",
    "number": "1811000201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12040 NE 128TH ST",
            "address_2": "MS #69",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343013",
            "telephone_number": "425-899-3455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12040 NE 128TH ST",
            "address_2": "MS #69",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343013",
            "telephone_number": "425-899-3455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUSE",
        "first_name": "MEAGAN",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2013-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "MD 00047991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.