Individual provider Active NPI

Anna Hancock, PA-C

  • Medical Physician Assistant
  • Issaquah, WA
National Provider Identifier
1932658564
Registry record updated Jun 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA60704122 Issued in VA
Practice address
100 NE Gilman Blvd
Issaquah, WA 98027
Phone
(425) 557-8000
Fax
(425) 557-8014
NPI assigned
Sep 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA60704122 VA Primary

Addresses

Primary practice location

100 NE Gilman Blvd
Issaquah, WA 98027

Mailing address

100 NE Gilman Blvd
Issaquah, WA 98027-2925
Phone (425) 557-8000

Other names 1

  • Anna Kvindlog 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
I20170125001364 WA Practitioner - Physician Assistant 5496037574 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
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)

19116 33Rd Ave W
Lynnwood, WA 98036-4706
Phone (425) 712-7900

380 Winslow Way E
Bainbridge Island, WA 98110-2424
Phone (206) 842-5632

4575 Sand Point Way NE
Suite 108
Seattle, WA 98105-3999
Phone (206) 525-8000

7315 212TH St SW
Edmonds, WA 98026-7610
Phone (425) 775-9474

925 Seneca St
Seattle, WA 98101-2742
Phone (206) 223-6600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA60704122VAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Mason Medical Center CurrentSince Aug 9, 2018 Accepting new patients
Virginia Mason Medical Center CurrentSince Aug 9, 2018 Accepting new patients

Locations

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

100 NE Gilman Blvd
Issaquah, WA 98027
Phone (425) 557-8000

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

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

Organizations & group practices 3

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 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": "1474588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560124800000",
    "number": "1932658564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NE GILMAN BLVD",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980272925",
            "telephone_number": "425-557-8000",
            "fax_number": "425-557-8014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NE GILMAN BLVD",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "98027",
            "telephone_number": "425-557-8000",
            "fax_number": "425-557-8014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANCOCK",
        "first_name": "ANNA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-23",
        "last_updated": "2019-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "PA60704122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNA",
            "last_name": "KVINDLOG",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Issaquah, WA

Sources for this page

Verify at the official NPI Registry.