NPIMap

Organization Active NPI

Pediatric Associates, Inc., Dba Allegro Pediatrics

Doing business as Allegro Pediatrics

  • Pediatrics Physician
  • Bothell, WA
National Provider Identifier
1912353111
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATRIC ASSOCIATES, INC., DBA ALLEGRO PEDIATRICS
Doing business as
Allegro Pediatrics
Practice address
11724 NE 195TH Street
Suite #100
Bothell, WA 98011
Phone
(425) 318-3100
NPI assigned
May 6, 2016
Last updated
Oct 27, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Authorized official

Name
Brett Vandenberg
Title
Ceo
Phone
(425) 460-5643

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

11724 NE 195TH Street
Suite #100
Bothell, WA 98011

Mailing address

2475 140TH Ave. NE, Building C
Bellevue, WA 98005
Phone (425) 460-5601

Other names 1

  • Allegro Pediatrics Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2072016Pediatric Associates11724 NE 195TH Ste 100, Bothell, WA 98011Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Associates Inc PS Dba Allegro Pediatrics9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

11724 NE 195th St
Ste 100
Bothell, WA 98011
Phone (425) 318-3100

19801 North Creek Pkwy
Ste 201
Bothell, WA 98011
Phone (425) 318-3100

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1462492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603756800000",
    "number": "1912353111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2475 140TH AVE. NE, BUILDING C",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98005",
            "telephone_number": "425-460-5601",
            "fax_number": "425-460-5606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11724 NE 195TH STREET",
            "address_2": "SUITE #100",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "98011",
            "telephone_number": "425-318-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ASSOCIATES, INC., DBA ALLEGRO PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-06",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A",
        "authorized_official_last_name": "VANDENBERG",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "425-460-5643"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Allegro Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Allegro Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bothell, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.