Individual provider Active NPI

Cally Espegard, P.A.

  • Physician Assistant
  • Bellevue, WA
National Provider Identifier
1932572344
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA61033557 Issued in WA
Practice address
1035 116TH Ave NE
Bellevue, WA 98004-4604
Phone
(425) 688-5100
NPI assigned
Nov 6, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085.005664 IL
Physician Assistant 363A00000X PA61033557 WA Primary

Addresses

Primary practice location

1035 116TH Ave NE
Bellevue, WA 98004-4604

Mailing address

1035 116TH Ave NE
Bellevue, WA 98004-4604

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20151125001221 IL Practitioner - Physician Assistant 0749580645 Reassigns benefits to 2 organizations
I20210709001620 WA Practitioner - Physician Assistant 0749580645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
86.73 of 100Reported as apm
Quality
73.46
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085.005664ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Overlake Medical Clinics, LLC CurrentSince Dec 15, 2021 Accepting new patients
Midwest Express Care 2, Inc CurrentSince Jan 1, 2020 Accepting new patients
Midwest Express Care 2, Inc CurrentSince Jan 1, 2020 Accepting new patients
Issaquah Obstetrics and Gynecology PLLC Past Accepting new patients

Locations

2868 N Broadway St
Chicago, IL 60657
Phone (773) 569-3525

1190 S Naper Blvd
Naperville, IL 60540
Phone (312) 229-0345

40 75th St
Willowbrook, IL 60527
Phone (630) 326-5312

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

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

1750 112th Ave NE
Ste B102
Bellevue, WA 98004
Phone (425) 688-5460

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 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1446768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1932572344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 116TH AVE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 116TH AVE NE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044604",
            "telephone_number": "425-688-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPEGARD",
        "first_name": "CALLY",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-06",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.005664",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA61033557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.