NPIMap

Individual provider Active NPI

Eric R Shipley, MD

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bellevue, WA
National Provider Identifier
1811099815
Registry record updated Jul 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X
License
MD00038537 Issued in WA
Practice address
1035 116TH Ave NE
Bellevue, WA 98004-4604
Phone
(425) 688-5124
NPI assigned
Sep 1, 2006
Last updated
Jul 30, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medical Services (Emergency Medicine) Physician 207PE0004X MD00038537 WA Primary

Addresses

Primary practice location

1035 116TH Ave NE
Bellevue, WA 98004-4604

Mailing address

PO Box 34960
Seattle, WA 98124-1960
Phone (425) 656-4255

Other identifiers 3

IdentifierTypeStateIssuer
8256299MedicaidWA
0185720OtherWALABOR&INDUSTRIES PROV #
5272SHOtherWAREGENCE B/S PROV #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050324000423 WA Practitioner - Emergency Medicine 2668449976 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Utah School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Puget Sound Physicians PLLCGroup PAC ID 2961301882, 47 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00038537WAMDEmergency Medical Services (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital District No 4 King County Washington CurrentSince Aug 1, 2019 Accepting new patients
Overlake Medical Clinics, LLC Current Accepting new patients
Puget Sound Physicians PLLC Emergency Medical Services CurrentSince Apr 1, 2001 Accepting new patients
Overlake Medical Clinics LLC CurrentSince Feb 7, 2005 Accepting new patients
Public Hospital District No 4 King County Washington CurrentSince Aug 1, 2019 Accepting new patients
Issaquah Obstetrics and Gynecology PLLC Past Accepting new patients
Public Hospital District No 4, King County Wa Past Accepting new patients
Associated Emergency Room Physicians, Inc P.S. PastSince Jan 10, 2021 Accepting new patients

Locations

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

1750 112th Ave NE
Ste B102
Bellevue, WA 98004
Phone (425) 688-5460

6520 226th Pl SE
Ste 150
Issaquah, WA 98027
Phone (425) 688-5777

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

9801 Frontier Ave SE
Snoqualmie, WA 98065
Phone (425) 831-2300

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Overlake Medical Center & ClinicsBellevue, WA, CCN 500051 Hospital Corporate Director Jan 1, 2024
Overlake Medical Center & ClinicsBellevue, WA, CCN 50S051 Hospital Corporate Director Jan 1, 2024

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280448000000",
    "number": "1811099815",
    "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": "425-656-4255",
            "fax_number": "425-656-4003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 116TH AVE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044604",
            "telephone_number": "425-688-5124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIPLEY",
        "first_name": "ERIC",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2010-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "WA",
            "license": "MD00038537",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8256299",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR&INDUSTRIES PROV #",
            "identifier": "0185720",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE B/S PROV #",
            "identifier": "5272SH",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.