Individual provider Active NPI

Blake Wachi, M.D.

  • Surgery Physician
  • Bellevue, WA
National Provider Identifier
1912393786
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD61069178 Issued in WA
Practice address
11695 NE 4TH St
Bellevue, WA 98004-5268
Phone
(425) 637-1855
Fax
(425) 344-7970
NPI assigned
Apr 8, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD61069178 WA Primary

Addresses

Primary practice location

11695 NE 4TH St
Bellevue, WA 98004-5268

Mailing address

11695 NE 4TH St
Bellevue, WA 98004-5268
Phone (425) 637-1855

Other practice location 1

333 City Blvd W
Suite 1600
Orange, CA 92868-2903
Phone (714) 456-6262

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bwachi635117@fhsce.catholichealth.net Direct

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201102001031 WA Practitioner - General Surgery 9032498431 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Medical College of Wisconsin, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virginia Mason Medical CenterGroup PAC ID 9830002617, 867 clinicians

Practice addresses (Care Compare)

11695 NE 4TH St
Bellevue, WA 98004-5268
Phone (425) 637-1855

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)36
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
145154CAMDMarriage & Family Therapist
MD61069178WAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Mason Medical Center Surgery CurrentSince Sep 8, 2022 Accepting new patients
Virginia Mason Medical Center Surgery CurrentSince Sep 8, 2022 Accepting new patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center Past Accepting new patients

Locations

380 Winslow Way E
Bainbridge Island, WA 98110
Phone (206) 842-5632

11695 NE 4th St
Bellevue, WA 98004
Phone (425) 637-1855

1100 9th Ave
Seattle, WA 98101
Phone (206) 223-6980

4575 Sand Point Way NE
Ste 108
Seattle, WA 98105
Phone (206) 525-8000

925 Seneca St
Seattle, WA 98101
Phone (206) 341-0860

Interoperability endpoints

  • Direct secure messaging: bwachi635117@fhsce.catholichealth.net

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

Hospital & facility affiliations 1

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": "1428451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1912393786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11695 NE 4TH ST",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980045268",
            "telephone_number": "425-637-1855",
            "fax_number": "425-344-7970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11695 NE 4TH ST",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980045268",
            "telephone_number": "425-637-1855",
            "fax_number": "425-344-7970"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 City Blvd W",
            "address_2": "Suite 1600",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "928682903",
            "country_code": "US",
            "telephone_number": "714-456-6262",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WACHI",
        "first_name": "BLAKE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-08",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD61069178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bwachi635117@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "11311 Bridgeport Way SW Ste 205",
            "city": "Lakewood",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984993051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.