Individual provider Active NPI

Kathy A Risse, MD

  • Pediatrics Physician
  • Seattle, WA
National Provider Identifier
1942393939
Registry record updated Nov 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD00037889 Issued in WA
Practice address
2671 NE 46TH St
Seattle, WA 98105-5041
Phone
(206) 525-8000
Fax
(206) 525-8070
NPI assigned
Oct 2, 2006
Last updated
Nov 26, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD00037889 WA Primary

Addresses

Primary practice location

2671 NE 46TH St
Seattle, WA 98105-5041

Mailing address

1100 9TH Ave
Ms: M4-PFS
Seattle, WA 98101-2756
Phone (206) 515-5811

Other identifiers 5

IdentifierTypeStateIssuer
0039577OtherWALABOR AND INDUSTRIES #
8291692MedicaidWA
7556RIOtherWABLUE SHIELD #
US7586226OtherWAAETNA SPECIALIST PIN
MD0948WMedicaidAK

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
I20040219000939 WA Practitioner - Pediatric Medicine 4880589696 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00037889WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Mason Medical Center Current Accepting new patients
Virginia Mason Medical Center CurrentSince Nov 3, 2018 Accepting new patients
Virginia Mason Medical Center Pediatrics CurrentSince Nov 3, 2018 Accepting new patients

Locations

1100 9th Ave
#M4
Seattle, WA 98101
Phone (206) 515-5811

2671 NE 46th St
Seattle, WA 98105
Phone (206) 525-8000

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

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

Interoperability endpoints

  • Direct secure messaging: kathy.risse@direct.vmmc.org
  • Direct secure messaging: krisse127546@direct.seattlechildrens.org

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

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385424000000",
    "number": "1942393939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 9TH AVE",
            "address_2": "MS: M4-PFS",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012756",
            "telephone_number": "206-515-5811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2671 NE 46TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981055041",
            "telephone_number": "206-525-8000",
            "fax_number": "206-525-8070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISSE",
        "first_name": "KATHY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2013-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00037889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES #",
            "identifier": "0039577",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8291692",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD #",
            "identifier": "7556RI",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA SPECIALIST PIN",
            "identifier": "US7586226",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MD0948W",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.