Douglas A Portelance, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD00024648 Issued in WA

Practice address

12333 NE 130TH LN
Ste 310
Kirkland, WA 98034

Phone

(425) 899-6700

Fax

(425) 899-6701

NPI assigned

Sep 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Internal Medicine

Education

University of Washington School of Medicine, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

King County Public Hospital District No 2Group PAC ID 7618880097, 586 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Evergreenhealth Home Care Services Home health agency, Kirkland, WA, CCN 507079
• Evergreenhealth Medical Center Hospital, Kirkland, WA, CCN 500124
• Evergreenhealth Monroe Hospital, Monroe, WA, CCN 500084

Merit-based Incentive Payment System (MIPS)

Final score

86.73 of 100Reported as apm

Quality

73.46

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• King County Public Hospital District No 2

  • Neuromusculoskeletal Medicine & OMM Physician
  • Kirkland, WA
  • NPI 1801986070
  Medicare reassignment Care Compare group NPD
• King County Public Hospital District No. 2

  • Physical Therapist
  • Kirkland, WA
  • NPI 1356920946
  NPD
• King County Public Hospital District No. 2

  • Clinic/Center
  • Redmond, WA
  • NPI 1750612883
  NPD
• King County Public Hospital District No 2

  • Family Medicine Physician
  • Bothell, WA
  • NPI 1902907165
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• King County Public Hospital District No. 2

  • General Acute Care Hospital
  • Kirkland, WA
  • NPI 1033174933
  Care Compare affiliation
• King County Public Hospital District No. 2

  • Home Health Agency
  • Kirkland, WA
  • NPI 1588662761
  Care Compare affiliation
• Public Hospital District 1 of Snohomish County

  • General Acute Care Hospital
  • Monroe, WA
  • NPI 1013074061
  Care Compare affiliation
• Public Hospital District No 1 of Snohomish County

  • Substance Use Disorder Rehabilitation Hospital Unit
  • Monroe, WA
  • NPI 1770614273
  Care Compare affiliation

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352678400000",
    "number": "1932291127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110456",
            "address_2": "MS 13739",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984110456",
            "telephone_number": "425-899-6700",
            "fax_number": "425-899-6701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12333 NE 130TH LN",
            "address_2": "STE 310",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "98034",
            "telephone_number": "425-899-6700",
            "fax_number": "425-899-6701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTELANCE",
        "first_name": "DOUGLAS",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2012-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD00024648",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRY",
            "identifier": "145685",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE HEALTH",
            "identifier": "0552PO",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lai Ha Esther Poon, D.C., L.AC
• Marius Pop
• Pamela Jo Pope, LIMHP CPC
• Laura N Popko
• Nabilla Shiraz Porbandarwalla, M.D.
• Brayden Porter
• Chris Allen Porter, LMP
• Jennifer K Porter, M.D.
• Nathaniel Zachariah Porter
• Positive Chiropractic and Wellness

• Internal Medicine Physician in Kirkland, WA
• Providers in Kirkland, WA by specialty
• Internal Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.