NPIMap

Individual provider Active NPI

Funke Adefope Wishko, MD

  • Family Medicine Physician
  • Kirkland, WA
National Provider Identifier
1841779485
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD61283257 Issued in WA
Practice address
12303 NE 130TH LN
Kirkland, WA 98034-3099
Phone
(425) 544-1000
Fax
(425) 544-1001
NPI assigned
Aug 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD61283257 WA Primary

Addresses

Primary practice location

12303 NE 130TH LN
Kirkland, WA 98034-3099

Mailing address

3612 216TH Dr SW
Brier, WA 98036-8096
Phone (470) 214-3374

Other identifiers 1

IdentifierTypeStateIssuer
LL3299OtherNVNEVADA STATE BOARD OF MEDICAL EXAMINERS

Other names 1

  • Funke Adefope Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221203000268 WA Practitioner - Family Practice 6204161896 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Select Outpatient Services IncGroup PAC ID 4082868815, 750 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

12303 NE 130TH LN
Suite 250
Kirkland, WA 98034-3072
Phone (425) 899-6414

2600 Compass Rd
Glenview, IL 60026-8001

Hospital & facility affiliations

  • Evergreenhealth Medical Center Hospital, Kirkland, WA, CCN 500124
  • Evergreenhealth Monroe Hospital, Monroe, WA, CCN 500084
  • Whidbeyhealth Medical Center Hospital, Coupeville, WA, CCN 501339

Merit-based Incentive Payment System (MIPS)

Final score
86.73 of 100Reported as apm
Quality
73.46
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No 2 Current Accepting new patients
King County Public Hospital District No. 2 Family Medicine CurrentSince Feb 3, 2023 Accepting new patients
King County Public Hospital District No 2 Family Medicine Current Accepting new patients
King County Public Hospital District No. 2 CurrentSince Feb 3, 2023 Accepting new patients
King County Public Hospital District No 2 Past Accepting new patients
The Medina Clinic, Incorporated Past Accepting new patients

Locations

1909 214th St SE
Ste 110
Bothell, WA 98021
Phone (425) 488-4988

14720 Main St NE
Ste 109
Duvall, WA 98019
Phone (425) 788-4889

12303 NE 130th Ln
Ste 250
Kirkland, WA 98034
Phone (425) 899-5900

12040 NE 128th St
#50
Kirkland, WA 98034
Phone (425) 899-1894

12303 NE 130th Ln
Kirkland, WA 98034
Phone (425) 317-4641

Organizations & group practices 7

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 9

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": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1841779485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3612 216TH DR SW",
            "city": "BRIER",
            "state": "WA",
            "postal_code": "980368096",
            "telephone_number": "470-214-3374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12303 NE 130TH LN",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343099",
            "telephone_number": "425-544-1000",
            "fax_number": "425-544-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISHKO",
        "first_name": "FUNKE",
        "middle_name": "ADEFOPE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-13",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61283257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEVADA STATE BOARD OF MEDICAL EXAMINERS",
            "identifier": "LL3299",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "FUNKE",
            "last_name": "ADEFOPE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.