Individual provider Active NPI

Hope Elizabeth Rutherford, PAC

  • Physician Assistant
  • Covington, WA
National Provider Identifier
1912244203
Registry record updated Jul 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA60318322 Issued in WA
Practice address
27500 168TH PL SE
Covington, WA 98042-5563
Phone
(425) 690-3435
Fax
(425) 690-9435
NPI assigned
Jan 7, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2020

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 PA60318322 WA Primary

Addresses

Primary practice location

27500 168TH PL SE
Covington, WA 98042-5563

Mailing address

3600 Lind Ave SW
Suite 100 Attn Credentialing
Renton, WA 98057-4970
Phone (425) 690-2715

Other practice location 1

10004 204th Ave E
#3400
Bonney Lake, WA 98391-6539
Phone (253) 848-5951

Other identifiers 1

IdentifierTypeStateIssuer
2024880MedicaidWA

Other names 1

  • Hope Elizabeth Roberts 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
I20130131000297 WA Practitioner - Physician Assistant 7113171059 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Overlake Medical Clinics LLCGroup PAC ID 7012808827, 423 clinicians

Practice addresses (Care Compare)

1135 116TH Ave NE
Suite 200
Bellevue, WA 98004-4695
Phone (425) 635-3400

17209 Redmond Way
Redmond, WA 98052-4404
Phone (425) 635-6400

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
Overlake Medical Clinics, LLC CurrentSince Sep 1, 2021 Accepting new patients
Issaquah Obstetrics and Gynecology PLLC Past Accepting new patients

Locations

1135 116th Ave NE
Ste 200
Bellevue, WA 98004
Phone (425) 635-3400

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

10223 NE 10th St
Bellevue, WA 98004
Phone (425) 453-3288

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

13159 Newcastle Commons Dr
Newcastle, WA 98059
Phone (425) 635-3010

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

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 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": "1357516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1912244203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 LIND AVE SW",
            "address_2": "SUITE 100 ATTN CREDENTIALING",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980574970",
            "telephone_number": "425-690-2715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27500 168TH PL SE",
            "city": "COVINGTON",
            "state": "WA",
            "postal_code": "980425563",
            "telephone_number": "425-690-3435",
            "fax_number": "425-690-9435"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10004 204th Ave E",
            "address_2": "#3400",
            "address_purpose": "LOCATION",
            "city": "Bonney Lake",
            "state": "WA",
            "postal_code": "983916539",
            "country_code": "US",
            "telephone_number": "253-848-5951",
            "fax_number": "253-845-7073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUTHERFORD",
        "first_name": "HOPE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-07",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60318322",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2024880",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HOPE",
            "last_name": "ROBERTS",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Covington, WA

Sources for this page

Verify at the official NPI Registry.