Individual provider Active NPI

Kelly Jean Adsero, PA-C

  • Physician Assistant
  • Seattle, WA
National Provider Identifier
1881872463
Registry record updated Feb 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1801 NW Market St
Suite 403
Seattle, WA 98107-3987
Phone
(206) 784-8833
Fax
(206) 784-0676
NPI assigned
Feb 5, 2008
Last updated
Feb 5, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1801 NW Market St
Suite 403
Seattle, WA 98107-3987

Mailing address

1801 NW Market St
Sutie 403
Seattle, WA 98107-3987
Phone (206) 784-8833

Other names 1

  • Ms. Kelly Jean Cooper Former name

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
I20080214000367 WA Practitioner - Physician Assistant 2860575883 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Overlake Medical Clinics LLCGroup PAC ID 7012808827, 423 clinicians
Puget Sound Physicians PLLCGroup PAC ID 2961301882, 47 clinicians

Practice addresses (Care Compare)

1750 112TH Ave NE
Suite B102
Bellevue, WA 98004-3772
Phone (425) 688-5460

3011 196TH St SW
Lynnwood, WA 98036-6925
Phone (425) 688-5759

5708 E Lake Samm Pkwy SE
Issaquah, WA 98029-8942
Phone (425) 688-5488

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington CurrentSince Jan 4, 2014 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Jan 4, 2014 Accepting new patients
Overlake Medical Clinics LLC CurrentSince Jul 1, 2015 Accepting new patients
Issaquah Obstetrics and Gynecology PLLC Past Accepting new patients

Locations

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

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

5708 E Lake Sammamish Pkwy SE
Ste 102
Issaquah, WA 98029
Phone (425) 688-5488

6520 226th Pl SE
Ste 150
Issaquah, WA 98027
Phone (425) 688-5777

17209 Redmond Way
Redmond, WA 98052
Phone (425) 635-6400

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

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

Hospital & facility affiliations 2

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": "1202169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202169600000",
    "number": "1881872463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 NW MARKET ST",
            "address_2": "SUTIE 403",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981073987",
            "telephone_number": "206-784-8833",
            "fax_number": "206-784-0676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 NW MARKET ST",
            "address_2": "SUITE 403",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981073987",
            "telephone_number": "206-784-8833",
            "fax_number": "206-784-0676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADSERO",
        "first_name": "KELLY",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-05",
        "last_updated": "2008-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "COOPER",
            "middle_name": "JEAN",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.