Individual provider Active NPI

Kirsten Elizabeth Wickstrom, DNP

  • Family Nurse Practitioner
  • Seattle, WA
National Provider Identifier
1821623257
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61166029 Issued in WA
Practice address
325 9TH Ave
Seattle, WA 98104-2420
Phone
(206) 520-5000
NPI assigned
Mar 5, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN60465203 WA
Family Nurse Practitioner 363LF0000X AP61166029 WA Primary

Addresses

Primary practice location

325 9TH Ave
Seattle, WA 98104-2420

Mailing address

PO Box 50095
Seattle, WA 98145-5095
Phone (206) 520-5700

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
I20220317001346 WA Practitioner - Nurse Practitioner 5890180483 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Association of University PhysiciansGroup PAC ID 0446162697, 3,484 clinicians

Practice addresses (Care Compare)

325 9TH Ave
Seattle, WA 98104-2420
Phone (206) 731-3000

Hospital & facility affiliations

  • Harborview Medical Center Hospital, Seattle, WA, CCN 500064

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
RN60465203WAMDNurse Practitioner
AP61166029WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborcare Health CurrentSince Jan 3, 2022 Accepting new patients
Neighborcare Health CurrentSince Jan 3, 2022 Accepting new patients
Neighborcare Health Current Accepting new patients
The Association of University Physicians CurrentSince Jul 12, 2023 Accepting new patients

Locations

4400 37th Ave S
Seattle, WA 98118
Phone (206) 296-4650

325 9th Ave
Seattle, WA 98104
Phone (206) 731-3000

1629 N 45th St
Seattle, WA 98103
Phone (206) 633-3350

9245 Rainier Ave S
Seattle, WA 98118
Phone (206) 461-6981

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

6020 35th Ave SW
Seattle, WA 98126
Phone (206) 461-6950

12721 30th Ave NE
Ste 101
Seattle, WA 98125
Phone (206) 417-0326

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

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": "1583366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1821623257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50095",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981455095",
            "telephone_number": "206-520-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 9TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042420",
            "telephone_number": "206-520-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKSTROM",
        "first_name": "KIRSTEN",
        "middle_name": "ELIZABETH",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-05",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "RN60465203",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61166029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.