Individual provider Active NPI

Alexander Gougoutas, MD

  • Plastic and Reconstructive Surgery Physician
  • Seattle, WA
National Provider Identifier
1821154790
Registry record updated Jun 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
MD60276102 Issued in WA
Practice address
1229 Madison St # 1660
Seattle, WA 98104-3586
Phone
(206) 860-5582
NPI assigned
Dec 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery Physician 2086S0122X MD60276102 WA Primary

Addresses

Primary practice location

1229 Madison St # 1660
Seattle, WA 98104-3586

Mailing address

7600 Evergreen Way
Everett, WA 98203-6421
Phone (206) 860-5414

Other identifiers 2

IdentifierTypeStateIssuer
1821154790MedicaidWA
8909038OtherWAMEDICARE PIN

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
I20120719000643 WA Practitioner - Plastic and Reconstructive Surgery 1951567916 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Perelman School of Med at the University of Pennsylvania, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Polyclinic PLLCGroup PAC ID 2163328196, 364 clinicians

Practice addresses (Care Compare)

1229 Madison St
Suite 1600
Seattle, WA 98104-3590
Phone (206) 860-5582

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision20

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60276102WAMDPlastic and Reconstructive Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Polyclinic PLLC CurrentSince Aug 8, 2023 Accepting new patients
The Polyclinic PLLC CurrentSince Aug 8, 2023 Accepting new patients
Optum Care Washington PLLC CurrentSince Jan 3, 2026 Accepting new patients
Optum Care Washington PLLC CurrentSince Jan 3, 2026 Accepting new patients
The Polyclinic PLLC PastSince Sep 17, 2023 Accepting new patients

Locations

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

1229 Madison St
Ste 1600
Seattle, WA 98104
Phone (206) 860-4541

1145 Broadway
Seattle, WA 98122

1229 Madison St
Ste 1660
Seattle, WA 98104
Phone (206) 860-5582

1201 N 175th St
Shoreline, WA 98133
Phone (425) 339-4299

Interoperability endpoints

  • Direct secure messaging: agougoutas78914@direct.tecmc.com
  • Direct secure messaging: agougout@yourcarecommunity.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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1821154790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 EVERGREEN WAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982036421",
            "telephone_number": "206-860-5414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1229 MADISON ST # 1660",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981043586",
            "telephone_number": "206-860-5582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOUGOUTAS",
        "first_name": "ALEXANDER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "WA",
            "license": "MD60276102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821154790",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "8909038",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.