NPIMap

Organization Active NPI

King County Public Hospital District No 2

  • Obstetrics Physician
  • Kirkland, WA
National Provider Identifier
1891883435
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics PhysicianTaxonomy code 207VX0000X
Legal business name
KING COUNTY PUBLIC HOSPITAL DISTRICT NO 2
Practice address
12040 NE 128TH St
Ms 105
Kirkland, WA 98034-3013
Phone
(425) 899-2560
Fax
(425) 899-2079
NPI assigned
Oct 10, 2006
Organization subpart
Yes
Parent organization
KING COUNTY PUBLIC HOSPITAL DISTRICT NO 2As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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

Authorized official

Name
Tina Christine Mycroft
Title
Cfo
Phone
(425) 899-2606

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VX0000X Primary

Addresses

Primary practice location

12040 NE 128TH St
Ms 105
Kirkland, WA 98034-3013

Mailing address

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

Other identifiers 5

IdentifierTypeStateIssuer
CJ9678OtherWAMEDICARE RAILROAD
CQ2437OtherWAMEDICARE RAILROAD
CG8137OtherWAMEDICARE RAILROAD
7127426MedicaidWA
CG2833OtherWAMEDICARE RAILROAD

Other names 1

  • Evergreen Healthcare OB Hospitalists Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031111000557 WA Part B Supplier - Clinic/Group Practice 7618880097 Receives reassigned benefits from 1,160 practitioners
27 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kirkland, WA; Mill Creek, WA; Monroe, WA; Redmond, WA; Sammamish, WA; Sultan, WA; Woodinville, WA; Bothell, WA…

Other NPIs on the same Medicare enrollment 27

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 27

National Provider Directory

National Provider Directory
Tax ID family
Ehmc Bothell Sr HLTH CT25 organizations share this tax ID, including this one
Part of
Ehmc Bothell Sr HLTH CT

Other organizations with this tax ID 24

Organizations that report the same tax identification number in the National Provider Directory.

View all 24

Locations

1909 214th St SE
Ste 120
Bothell, WA 98021

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

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

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

13030 121st Way NE
Ste 203
Kirkland, WA 98034
Phone (206) 820-0740

12040 NE 128th St
Ste MS119
Kirkland, WA 98034

12333 NE 130th Ln
Ste 110
Kirkland, WA 98034
Phone (425) 285-0060

Practitioners & affiliated clinicians

Practitioners 160

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 160

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657152000000",
    "number": "1891883435",
    "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": "12040 NE 128TH ST",
            "address_2": "MS 105",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343013",
            "telephone_number": "425-899-2560",
            "fax_number": "425-899-2079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KING COUNTY PUBLIC HOSPITAL DISTRICT NO 2",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KING COUNTY PUBLIC HOSPITAL DISTRICT NO 2",
        "enumeration_date": "2006-10-10",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A",
        "authorized_official_last_name": "MYCROFT",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "CHRISTINE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "425-899-2606"
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CJ9678",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CQ2437",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CG8137",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7127426",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "CG2833",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen Healthcare OB Hospitalists",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Evergreen Healthcare OB Hospitalists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.