Individual provider Active NPI

Sarinda Kongkachen, MD

  • Family Medicine Physician
  • Bothell, WA
National Provider Identifier
1942593587
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD60733286 Issued in WA
Practice address
1909 214TH St SE Ste 110
Bothell, WA 98021-4412
Phone
(425) 488-4988
Fax
(425) 488-4993
NPI assigned
May 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301098354 MI
Family Medicine Physician 207Q00000X MD165772 OR
Family Medicine Physician 207Q00000X MD60733286 WA Primary

Addresses

Primary practice location

1909 214TH St SE Ste 110
Bothell, WA 98021-4412

Mailing address

PO Box 5127
Everett, WA 98206-5127
Phone (425) 397-1700

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
I20170518001164 WA Practitioner - Family Practice 8921226549 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2008
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)

1909 214TH St SE
Suite 110
Bothell, WA 98021-4412
Phone (425) 488-4988

Hospital & facility affiliations

  • 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

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301098354MIMDFamily Medicine Physician
MD165772ORMDFamily Medicine Physician
MD60733286WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No 2 Current Accepting new patients
King County Public Hospital District No. 2 Family Medicine Current Accepting new patients
King County Public Hospital District No. 2 CurrentSince Nov 1, 2022 Accepting new patients
King County Public Hospital District No 2 Family Medicine CurrentSince Nov 1, 2022 Accepting new patients

Locations

1909 214th St SE
Ste 110
Bothell, WA 98021
Phone (425) 488-4988

1909 214th St SE
Ste 100
Bothell, WA 98021
Phone (425) 488-4988

14720 Main St NE
Ste 109
Duvall, WA 98019
Phone (425) 788-4889

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1305504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1942593587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5127",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982065127",
            "telephone_number": "425-397-1700",
            "fax_number": "425-335-5145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1909 214TH ST SE STE 110",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980214412",
            "telephone_number": "425-488-4988",
            "fax_number": "425-488-4993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONGKACHEN",
        "first_name": "SARINDA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-16",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301098354",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD165772",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60733286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bothell, WA

Sources for this page

Verify at the official NPI Registry.