Individual provider Active NPI

Katherine Ziwisky

  • Physician Assistant
  • Renton, WA
National Provider Identifier
1811399660
Registry record updated Apr 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61249152 Issued in WA
Practice address
4033 Talbot Rd S Ste 570
Renton, WA 98055-5700
Phone
(425) 690-3487
Fax
(425) 690-9087
NPI assigned
Sep 24, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085005136 IL
Physician Assistant 363A00000X 53336 CA
Physician Assistant 363A00000X PA61249152 WA Primary

Addresses

Primary practice location

4033 Talbot Rd S Ste 570
Renton, WA 98055-5700

Mailing address

4033 Talbot Rd S Ste 570
Renton, WA 98055-5700
Phone (425) 690-3487

Other practice location 1

15644 Pomerado Rd
Suite 202
Poway, CA 92064-2400
Phone (858) 312-5459

Other names 1

  • Katherine Rachel Fleming Former name

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220502001060 WA Practitioner - Physician Assistant 1254553563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Valley Medical Group-RentonGroup PAC ID 4183753965, 419 clinicians

Practice addresses (Care Compare)

16850 SE 272ND St
Covington, WA 98042-4931

400 S 43Rd St
Renton, WA 98055-5714
Phone (425) 228-3450

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
53336CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital District #1 of King County Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kziwisky97857@direct.valleymed.org

Organizations & group practices 2

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 2

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": "1411516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650844800000",
    "number": "1811399660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4033 TALBOT RD S STE 570",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555700",
            "telephone_number": "425-690-3487",
            "fax_number": "425-690-9087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4033 TALBOT RD S STE 570",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555700",
            "telephone_number": "425-690-3487",
            "fax_number": "425-690-9087"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15644 Pomerado Rd",
            "address_2": "Suite 202",
            "address_purpose": "LOCATION",
            "city": "Poway",
            "state": "CA",
            "postal_code": "920642400",
            "country_code": "US",
            "telephone_number": "858-312-5459",
            "fax_number": "858-345-3743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZIWISKY",
        "first_name": "KATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-24",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085005136",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "53336",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61249152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "FLEMING",
            "middle_name": "RACHEL",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.