Individual provider Active NPI

Kirby F. Meyer, PA-C

  • Physician Assistant
  • Lynnwood, WA
National Provider Identifier
1811969769
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10004198 Issued in WA
Practice address
19020 33Rd Ave W Ste 210
Lynnwood, WA 98036-4748
Phone
(425) 563-1500
Fax
(425) 563-1501
NPI assigned
Feb 5, 2006
Sex
Male
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
Medical Physician Assistant 363AM0700X PA10004198 WA
Physician Assistant 363A00000X PA10004198 WA Primary

Addresses

Primary practice location

19020 33Rd Ave W Ste 210
Lynnwood, WA 98036-4748

Mailing address

19020 33Rd Ave W Ste 210
Lynnwood, WA 98036-4748
Phone (425) 563-1500

Other identifiers 1

IdentifierTypeStateIssuer
1019654MedicaidWA

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
I20040903000376 WA Practitioner - Physician Assistant 4183690878 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radia Inc P SGroup PAC ID 9931012812, 275 clinicians

Practice addresses (Care Compare)

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

12040 NE 128TH St
Kirkland, WA 98034-3013
Phone (425) 899-1800

21601 76TH Ave W
Edmonds, WA 98026-7507
Phone (425) 563-1500

500 17TH Ave
Seattle, WA 98122-5711
Phone (206) 320-3700

700 Minor Ave
Seattle, WA 98104-2146
Phone (425) 563-1500

747 Broadway
Seattle, WA 98122-4379
Phone (206) 386-6000

747 Broadway RM
Suite 404
Seattle, WA 98122-4379
Phone (206) 386-6000

751 NE Blakely Dr
Issaquah, WA 98029-6201

Hospital & facility affiliations

  • Evergreenhealth Medical Center Hospital, Kirkland, WA, CCN 500124
  • Overlake Hospital Medical Center & Clinics Hospital, Bellevue, WA, CCN 500051
  • Swedish Issaquah Hospital, Issaquah, WA, CCN 500152
  • Swedish Medical Center Hospital, Seattle, WA, CCN 500027
  • Swedish Medical Center / Cherry Hill Hospital, Seattle, WA, CCN 500025

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc P S CurrentSince Jun 14, 2022 Accepting new patients
Proliance Surgeons, Inc., P.S. Physician Assistant CurrentSince Jun 14, 2022 Accepting new patients
Seattle Childrens Hospital CurrentSince Jul 7, 2008 Accepting new patients
Radia Inc P S CurrentSince Mar 20, 2020 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Dec 8, 2004 Accepting new patients
Radia Imaging Center Holdings LLC CurrentSince Mar 20, 2020 Accepting new patients

Locations

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

1100 Pacific Ave
Ste 300
Everett, WA 98201
Phone (425) 337-7000

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

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

19020 33rd Ave W
Ste 210
Lynnwood, WA 98036
Phone 42556315001

1025 153rd St SE
Ste 200
Mill Creek, WA 98012
Phone (425) 338-4000

14701 179th Ave SE
Monroe, WA 98272
Phone (360) 794-1409

3030 Limited Ln NW
Olympia, WA 98502
Phone (360) 352-6000

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

1229 Madison St
Ste 900
Seattle, WA 98104
Phone (206) 292-6233

500 17th Ave
Seattle, WA 98122
Phone (206) 320-2111

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

601 Broadway
Fl 6
Seattle, WA 98122
Phone (206) 633-8100

1780 NW Myhre Rd
Ste 2120
Silverdale, WA 98383
Phone (360) 782-3100

10452 Silverdale Way NW
Silverdale, WA 98383
Phone (360) 307-7300

209 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 596-3300

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 6

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": "1139097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593475200000",
    "number": "1811969769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19020 33RD AVE W STE 210",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364748",
            "telephone_number": "425-563-1500",
            "fax_number": "425-563-1374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19020 33RD AVE W STE 210",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364748",
            "telephone_number": "425-563-1500",
            "fax_number": "425-563-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYER",
        "first_name": "KIRBY",
        "middle_name": "F.",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-05",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10004198",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10004198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1019654",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

Verify at the official NPI Registry.