Active NPI
Simon Brisebois, M.D.
- Otolaryngology Physician
- Seattle, WA
National Provider Identifier
1891204012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- MD60751402
- Practice address
- 1959 NE Pacific St
Seattle, WA 98195 - Phone
- (206) 543-8383
- Fax
- (206) 543-5152
- NPI assigned
- Sep 20, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | MD60751402 | WA | Primary |
Addresses
Primary practice location
1959 NE Pacific St
Seattle, WA 98195
Mailing address
1959 NE Pacific St, Box 356515
Seattle, WA 98195
Phone (206) 543-8383
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD60751402 | WA | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505865600000",
"number": "1891204012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1959 NE PACIFIC ST, BOX 356515",
"city": "SEATTLE",
"state": "WA",
"postal_code": "98195",
"telephone_number": "206-543-8383",
"fax_number": "206-543-5152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1959 NE PACIFIC ST",
"city": "SEATTLE",
"state": "WA",
"postal_code": "98195",
"telephone_number": "206-543-8383",
"fax_number": "206-543-5152"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRISEBOIS",
"first_name": "SIMON",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-09-20",
"last_updated": "2017-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "WA",
"license": "MD60751402",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.