Individual provider Active NPI

Calvin H Knapp Jr., MD

  • Otolaryngology Physician
  • Seattle, WA
National Provider Identifier
1841258019
Registry record updated Mar 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD00027495 Issued in WA
Practice address
515 Minor Ave
Suite 140
Seattle, WA 98104-2133
Phone
(206) 838-8345
Fax
(206) 838-8346
NPI assigned
May 3, 2006
Last updated
Mar 31, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD00027495 WA Primary

Addresses

Primary practice location

515 Minor Ave
Suite 140
Seattle, WA 98104-2133

Mailing address

805 Madison St
Suite 901
Seattle, WA 98104-1172
Phone (206) 264-8100

Other identifiers 2

IdentifierTypeStateIssuer
0781KNOtherWAREGENCE
1057835MedicaidWA

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
I20070201000356 WA Practitioner - Otolaryngology 5597767764 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00027495WAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc P S Current Accepting new patients
Proliance Surgeons Inc P S CurrentSince Apr 4, 2016 Accepting new patients
Proliance Surgeons, Inc., P.S. Otolaryngology CurrentSince Apr 4, 2016 Accepting new patients
Seattle Head, Neck & Plastic Surgeons, PLLC PastSince Jun 23, 2008 Accepting new patients

Locations

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

3236 78th Ave SE
Ste 200
Mercer Island, WA 98040
Phone (206) 275-5060

515 Minor Ave
Ste 140
Seattle, WA 98104
Phone (206) 682-6103

515 Minor Ave
Ste 230
Seattle, WA 98104
Phone (206) 539-0675

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

Interoperability endpoints

  • Direct secure messaging: cknapp1042162@wm.providencedirect.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459382400000",
    "number": "1841258019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 MADISON ST",
            "address_2": "SUITE 901",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041172",
            "telephone_number": "206-264-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 MINOR AVE",
            "address_2": "SUITE 140",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042133",
            "telephone_number": "206-838-8345",
            "fax_number": "206-838-8346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNAPP",
        "first_name": "CALVIN",
        "middle_name": "H",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2016-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WA",
            "license": "MD00027495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "0781KN",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1057835",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.