NPIMap

Organization Active NPI

Overlake Obstetricians & Gynecologist P S

  • Obstetrics & Gynecology Physician
  • Bellevue, WA
National Provider Identifier
1972539401
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
600035651 Issued in WA
Legal business name
OVERLAKE OBSTETRICIANS & GYNECOLOGIST P S
Practice address
1231 116TH Ave NE
Suite 950
Bellevue, WA 98004-3804
Phone
(425) 454-3366
Fax
(425) 460-5954
NPI assigned
Jun 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

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

Authorized official

Name
Jonathan I Paley, MD
Title
President
Phone
(425) 943-3230

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207V00000X 600035651 WA Primary

Addresses

Primary practice location

1231 116TH Ave NE
Suite 950
Bellevue, WA 98004-3804

Mailing address

1231 116TH Ave NE
Suite 950
Bellevue, WA 98004-3804
Phone (425) 454-3366

Other identifiers 1

IdentifierTypeStateIssuer
7020803MedicaidWA

Other names 1

  • Overlake Obstetricians & Gynecologist PS Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663718400000",
    "number": "1972539401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1231 116TH AVE NE",
            "address_2": "SUITE 950",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043804",
            "telephone_number": "425-454-3366",
            "fax_number": "425-460-5954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 116TH AVE NE",
            "address_2": "SUITE 950",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043804",
            "telephone_number": "425-454-3366",
            "fax_number": "425-460-5954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OVERLAKE OBSTETRICIANS & GYNECOLOGIST P S",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A",
        "authorized_official_last_name": "PALEY",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-943-3230",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "600035651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7020803",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Overlake Obstetricians & Gynecologist PS",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Bellevue, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.