Individual provider Active NPI

Kylie Ann Smith, D.O.

  • Obstetrics & Gynecology Physician
  • Renton, WA
National Provider Identifier
1871736041
Registry record updated Oct 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
OP 60286079 Issued in WA
Practice address
4011 Talbot Rd S
Suite 430
Renton, WA 98055-5773
Phone
(425) 251-3454
Fax
(425) 264-3201
NPI assigned
Apr 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X OP 60286079 WA Primary

Addresses

Primary practice location

4011 Talbot Rd S
Suite 430
Renton, WA 98055-5773

Mailing address

4011 Talbot Rd S
Suite 430
Renton, WA 98055-5773
Phone (425) 251-3454

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
I20120808000677 WA Practitioner - Obstetrics/Gynecology 5496901373 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Obhg Washington PCGroup PAC ID 0345364642, 44 clinicians

Practice addresses (Care Compare)

1035 116TH Ave NE
Bellevue, WA 98004-4604
Phone (800) 967-2289

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OP 60286079WAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No 2 CurrentSince Mar 1, 2022 Accepting new patients
Overlake Medical Clinics LLC CurrentSince Dec 6, 2021 Accepting new patients
King County Public Hospital District No. 2 CurrentSince Mar 1, 2022 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
Overlake Medical Clinics, LLC Current Accepting new patients
Bellegrove OB/GYN, Inc. PS Obstetrics & Gynecology Past Accepting new patients
King County Public Hospital District No. 2 Past Accepting new patients

Locations

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

1200 112th Ave NE
Ste C115
Bellevue, WA 98004
Phone (425) 455-0244

1750 112th Ave NE
Ste B102
Bellevue, WA 98004
Phone (425) 688-5460

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

12303 NE 130th Ln
Ste 450
Kirkland, WA 98034
Phone (425) 899-5000

Organizations & group practices 8

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": "1239926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350000000000",
    "number": "1871736041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4011 TALBOT RD S",
            "address_2": "SUITE 430",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555773",
            "telephone_number": "425-251-3454",
            "fax_number": "425-264-3201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 TALBOT RD S",
            "address_2": "SUITE 430",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555773",
            "telephone_number": "425-251-3454",
            "fax_number": "425-264-3201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "KYLIE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-17",
        "last_updated": "2012-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "OP 60286079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.