NPIMap

Individual provider Active NPI

Vernan I Atienza

  • Geriatric Medicine (Internal Medicine) Physician
  • Kirkland, WA
National Provider Identifier
1851402440
Registry record updated Jun 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
MD00041820 Issued in WA
Practice address
11521 NE 128TH St
Suite 100
Kirkland, WA 98034-4317
Phone
(425) 899-6800
Fax
(425) 899-6808
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 036107853 IL
Geriatric Medicine (Internal Medicine) Physician 207RG0300X MD00041820 WA Primary

Addresses

Primary practice location

11521 NE 128TH St
Suite 100
Kirkland, WA 98034-4317

Mailing address

PO Box 34036
Seattle, WA 98124-1036
Phone (425) 899-3292

Other identifiers 2

IdentifierTypeStateIssuer
036107853MedicaidIL
8508798MedicaidWA

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
I20080423000756 WA Practitioner - Geriatric MedicinePractitioner - Family Practice 3870560527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Family Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

11521 NE 128TH St
Kirkland, WA 98034-4317

12303 NE 130TH LN
Kirkland, WA 98034-3041

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036107853ILMDGeriatric Medicine (Internal Medicine) Physician
MD00041820WAMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No. 2 CurrentSince Apr 14, 2008 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
King County Public Hospital District No 2 CurrentSince Apr 14, 2008 Accepting new patients
King County Public Hospital District No 2 Past Accepting new patients

Locations

12039 NE 128th St
Ste 300
Kirkland, WA 98034
Phone (425) 899-3123

12040 NE 128th St
Kirkland, WA 98034
Phone (425) 899-1000

12303 NE 130th Ln
Ste 400
Kirkland, WA 98034
Phone (425) 450-7007

11521 NE 128th St
Ste 100
Kirkland, WA 98034
Phone (425) 899-6800

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 4

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245110400000",
    "number": "1851402440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34036",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241036",
            "telephone_number": "425-899-3292",
            "fax_number": "425-899-3269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11521 NE 128TH ST",
            "address_2": "SUITE 100",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980344317",
            "telephone_number": "425-899-6800",
            "fax_number": "425-899-6808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATIENZA",
        "first_name": "VERNAN",
        "middle_name": "I",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2009-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "036107853",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "WA",
            "license": "MD00041820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036107853",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8508798",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

Verify at the official NPI Registry.