Individual provider Active NPI

Diana K Koala, MD

  • Obstetrics & Gynecology Physician
  • Seattle, WA
National Provider Identifier
1811969801
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD00037938 Issued in WA
Practice address
1101 Madison St
Suite 950
Seattle, WA 98104-3592
Phone
(206) 682-5800
Fax
(206) 233-9657
NPI assigned
Feb 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD00037938 WA Primary

Addresses

Primary practice location

1101 Madison St
Suite 950
Seattle, WA 98104-3592

Mailing address

1101 Madison St
Suite 950
Seattle, WA 98104-3592
Phone (206) 682-5800

Other identifiers 1

IdentifierTypeStateIssuer
7086887MedicaidWA

Other names 1

  • Diana Gibford 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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060110000954 WA Practitioner - Obstetrics/Gynecology 5991728438 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Washington School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Womens Healthcare Alliance PLLCGroup PAC ID 9234451626, 15 clinicians

Practice addresses (Care Compare)

1101 Madison St
Suite 1150
Seattle, WA 98104-3558
Phone (206) 386-3400

Hospital & facility affiliations

  • Swedish Medical Center Hospital, Seattle, WA, CCN 500027

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons, Inc., P.S. Obstetrics & Gynecology CurrentSince Apr 1, 2017 Accepting new patients
Proliance Surgeons Inc P S CurrentSince Apr 1, 2017 Accepting new patients
Proliance Surgeons Inc P S Current Accepting new patients

Locations

510 8th Ave NE
Ste 200
Issaquah, WA 98029
Phone (425) 392-3030

1101 Madison St
Ste 1150
Seattle, WA 98104
Phone (206) 386-3400

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

1101 Madison St
Ste 950
Seattle, WA 98104
Phone (206) 355-0800

Organizations & group practices 4

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 1

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": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811969801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 MADISON ST",
            "address_2": "SUITE 950",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981043592",
            "telephone_number": "206-682-5800",
            "fax_number": "206-233-9657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MADISON ST",
            "address_2": "SUITE 950",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981043592",
            "telephone_number": "206-682-5800",
            "fax_number": "206-233-9657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOALA",
        "first_name": "DIANA",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "MD00037938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7086887",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "GIBFORD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.