NPIMap

Individual provider Active NPI

Kristi S. Moffat, MD

  • Family Medicine Physician
  • Duvall, WA
National Provider Identifier
1962503235
Registry record updated Oct 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00038948 Issued in WA
Practice address
14720 Main St NE
Suite 109
Duvall, WA 98019-8460
Phone
(425) 788-4889
Fax
(425) 844-6116
NPI assigned
Sep 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00038948 WA Primary

Addresses

Primary practice location

14720 Main St NE
Suite 109
Duvall, WA 98019-8460

Mailing address

PO Box 34036
Seattle, WA 98124-1036
Phone (425) 899-3292

Other identifiers 1

IdentifierTypeStateIssuer
8291858MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040708000306 WA Practitioner - Family Practice 8729066709 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Chicago College of Medicine and Surgery, 1998
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)

14720 Main St NE
Suite 109
Duvall, WA 98019-8460
Phone (425) 788-4889

8980 161St Ave NE
Redmond, WA 98052-7554

Hospital & facility affiliations

  • Evergreenhealth Home Care Services Home health agency, Kirkland, WA, CCN 507079
  • Evergreenhealth Medical Center Hospital, Kirkland, WA, CCN 500124
  • Evergreenhealth Monroe Hospital, Monroe, WA, CCN 500084
  • Overlake Hospital Medical Center & Clinics Hospital, Bellevue, WA, CCN 500051

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00038948WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No. 2 Family Medicine Current Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
King County Public Hospital District No. 2 CurrentSince Sep 2, 2009 Accepting new patients
King County Public Hospital District No 2 Family Medicine CurrentSince Sep 2, 2009 Accepting new patients

Locations

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

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

12039 NE 128th St
Ste 300
Kirkland, WA 98034
Phone (425) 899-3123

12040 NE 128th St
Ofc
Kirkland, WA 98034

8980 161st Ave NE
Ste 400
Redmond, WA 98052
Phone (425) 883-3404

1959 NE Pacific St
Seattle, WA 98195
Phone (206) 598-4333

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 6

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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255651200000",
    "number": "1962503235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34036",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241036",
            "telephone_number": "425-899-3292",
            "fax_number": "425-899-3269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14720 MAIN ST NE",
            "address_2": "SUITE 109",
            "city": "DUVALL",
            "state": "WA",
            "postal_code": "980198460",
            "telephone_number": "425-788-4889",
            "fax_number": "425-844-6116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFFAT",
        "first_name": "KRISTI",
        "middle_name": "S.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2009-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00038948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8291858",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duvall, WA

Sources for this page

Verify at the official NPI Registry.