Individual provider Active NPI

Maureen Batterberry, PA C

  • Physician Assistant
  • Federal Way, WA
National Provider Identifier
1962450064
Registry record updated Aug 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10003763 Issued in WA
Practice address
34515 9TH Ave S
Federal Way, WA 98003-6761
Phone
(253) 952-7971
Fax
(253) 944-7922
NPI assigned
May 4, 2006
Last updated
Aug 25, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10003763 WA Primary

Addresses

Primary practice location

34515 9TH Ave S
Federal Way, WA 98003-6761

Mailing address

505 S 336TH St
Suite 600
Federal Way, WA 98003-6328
Phone (253) 838-6180

Other identifiers 4

IdentifierTypeStateIssuer
8325466MedicaidWA
3451MCOtherWABSWA
5614BAOtherWABLUE SHIELD # VM
0189524OtherWALIWA

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
I20050413000529 WA Practitioner - Physician Assistant 3678510468 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Overlake Medical Clinics LLCGroup PAC ID 7012808827, 423 clinicians

Practice addresses (Care Compare)

17209 Redmond Way
Redmond, WA 98052-4404
Phone (425) 635-6400

1750 112TH Ave NE
Suite B102
Bellevue, WA 98004-3772
Phone (425) 688-5460

5708 E Lake Samm Pkwy SE
Issaquah, WA 98029-8942
Phone (425) 688-5488

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Overlake Medical Clinics LLC CurrentSince Jun 1, 2016 Accepting new patients
Issaquah Obstetrics and Gynecology PLLC Past Accepting new patients
Northwest Physician Associates, Apc Past Accepting new patients
Associated Emergency Room Physicians, Inc P.S. PastSince Jan 10, 2021 Accepting new patients
Radia Inc P S Past Accepting new patients

Locations

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

619 156th Ave SE
Bellevue, WA 98007
Phone (425) 637-3270

5708 E Lake Sammamish Pkwy SE
Ste 102
Issaquah, WA 98029
Phone (425) 688-5488

6520 226th Pl SE
Ste 150
Issaquah, WA 98027
Phone (425) 688-5777

17209 Redmond Way
Redmond, WA 98052
Phone (425) 635-6400

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219622400000",
    "number": "1962450064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S 336TH ST",
            "address_2": "SUITE 600",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036328",
            "telephone_number": "253-838-6180",
            "fax_number": "253-838-6418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34515 9TH AVE S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980036761",
            "telephone_number": "253-952-7971",
            "fax_number": "253-944-7922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BATTERBERRY",
        "first_name": "MAUREEN",
        "credential": "PA C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2008-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10003763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8325466",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSWA",
            "identifier": "3451MC",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD #  VM",
            "identifier": "5614BA",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIWA",
            "identifier": "0189524",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

Verify at the official NPI Registry.