NPIMap

Individual provider Active NPI

Kerry Ellen Meyer, ARNP

  • Family Nurse Practitioner
  • Renton, WA
National Provider Identifier
1811132178
Registry record updated Sep 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP30003229 Issued in WA
Practice address
4033 Talbot Rd S
Ste 570
Renton, WA 98055-5772
Phone
(425) 656-5400
Fax
(425) 656-5079
NPI assigned
Dec 15, 2008
Last updated
Sep 10, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP30003229 WA Primary

Addresses

Primary practice location

4033 Talbot Rd S
Ste 570
Renton, WA 98055-5772

Mailing address

PO Box 34876
Seattle, WA 98124-1876
Phone (425) 656-5412

Other names 1

  • Kerry Ellen Petrucci Former name

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
I20090501000073 WA Practitioner - Nurse Practitioner 1052469061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Association of University PhysiciansGroup PAC ID 0446162697, 3,484 clinicians
Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

1740 NW Maple St
Suite 100
Issaquah, WA 98027-8127
Phone (425) 391-3900

2600 Compass Rd
Glenview, IL 60026-8001

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.85 of 100Reported as apm
Quality
74.6
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP30003229WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Association of University Physicians CurrentSince Feb 1, 2013 Accepting new patients
Bourget Health Services Inc Past Accepting new patients
Association of University Physicians Past Accepting new patients
Public Hospital District 1 of King County Past Accepting new patients

Locations

1740 NW Maple St
Ste 100
Issaquah, WA 98027
Phone (425) 391-3900

400 S 43rd St
Renton, WA 98055
Phone (425) 228-3450

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

Interoperability endpoints

  • Direct secure messaging: kmeyer208778@direct.ehre.uwmedicine.org

Organizations & group practices 5

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 4

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": "1229299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347235200000",
    "number": "1811132178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34876",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241876",
            "telephone_number": "425-656-5412",
            "fax_number": "425-656-4096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4033 TALBOT RD S",
            "address_2": "STE 570",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555772",
            "telephone_number": "425-656-5400",
            "fax_number": "425-656-5079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYER",
        "first_name": "KERRY",
        "middle_name": "ELLEN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-15",
        "last_updated": "2012-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP30003229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERRY",
            "last_name": "PETRUCCI",
            "middle_name": "ELLEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.