Individual provider Active NPI

Gregory A Komenda, M.D.

  • Orthopaedic Surgery Physician
  • Bellevue, WA
National Provider Identifier
1972562528
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD00035536 Issued in WA
Practice address
3101 Northup Way Ste 201
Bellevue, WA 98004-1449
Phone
(425) 455-3600
Fax
(425) 455-3920
NPI assigned
Mar 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD00035536 WA Primary

Addresses

Primary practice location

3101 Northup Way Ste 201
Bellevue, WA 98004-1449

Mailing address

510 8TH Ave NE Ste 320
Issaquah, WA 98029-5436
Phone (425) 455-3600

Other practice location 1

510 8th Ave NE Ste 200
Issaquah, WA 98029-5436
Phone (425) 392-3030

Other practice location 2

515 Minor Ave Ste 200
Seattle, WA 98104-2133
Phone (425) 455-3600

Other practice location 3

18100 NE Union Hill Rd Ste 330
Redmond, WA 98052-3330
Phone (425) 455-3600

Other identifiers 4

IdentifierTypeStateIssuer
200029611OtherWAMEDICARE RR KING CO.
G8854590OtherWAMEDICARE EMRI
0117250OtherWAL & I
G8861208OtherWAMEDICARE POSM

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
I20050713000322 WA Practitioner - Orthopedic Surgery 5092763029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Saint Louis University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Proliance Surgeons Inc P SGroup PAC ID 8527972900, 395 clinicians

Practice addresses (Care Compare)

1231 116TH Ave NE
Suite 915
Bellevue, WA 98004-3822
Phone (425) 454-3938

Hospital & facility affiliations

  • Swedish Issaquah Hospital, Issaquah, WA, CCN 500152
  • Overlake Hospital Medical Center & Clinics Hospital, Bellevue, WA, CCN 500051

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement23
Lower limb (leg) arthroscopy (minimally invasive joint repair)21
Upper limb (arm) arthroscopy (minimally invasive joint repair)45

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00035536WAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons Inc P S Orthopaedic Surgery CurrentSince Sep 30, 1997 Accepting new patients
Proliance Surgeons Inc P S Orthopaedic Surgery Current Accepting new patients
Proliance Surgeons, Inc., P.S. CurrentSince Sep 30, 1997 Accepting new patients
Proliance Surgeons, Inc., P.S. Past Accepting new patients

Locations

3101 Northup Way
Ste 201
Bellevue, WA 98004
Phone (425) 455-3600

1231 116th Ave NE
Ste 915
Bellevue, WA 98004
Phone (425) 454-3938

1231 116th Ave NE
Ste 750
Bellevue, WA 98004
Phone (425) 455-3600

1135 116th Ave NE
Ste 510
Bellevue, WA 98004
Phone (425) 455-3600

510 8th Ave NE
Ste 200
Issaquah, WA 98029
Phone (425) 392-3030

12911 120th Ave NE
Ste H120
Kirkland, WA 98034
Phone (425) 823-4226

18100 NE Union Hill Rd
Ste 330
Redmond, WA 98052
Phone (425) 392-3030

515 Minor Ave
Ste 200
Seattle, WA 98104
Phone (206) 386-9615

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

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": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1972562528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 8TH AVE NE STE 320",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980295436",
            "telephone_number": "425-455-3600",
            "fax_number": "425-455-3920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 NORTHUP WAY STE 201",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980041449",
            "telephone_number": "425-455-3600",
            "fax_number": "425-455-3920"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "510 8th Ave NE Ste 200",
            "address_purpose": "LOCATION",
            "city": "Issaquah",
            "state": "WA",
            "postal_code": "980295436",
            "country_code": "US",
            "telephone_number": "425-392-3030",
            "fax_number": "425-392-2564",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "515 Minor Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981042133",
            "country_code": "US",
            "telephone_number": "425-455-3600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18100 NE Union Hill Rd Ste 330",
            "address_purpose": "LOCATION",
            "city": "Redmond",
            "state": "WA",
            "postal_code": "980523330",
            "country_code": "US",
            "telephone_number": "425-455-3600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOMENDA",
        "first_name": "GREGORY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WA",
            "license": "MD00035536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR KING CO.",
            "identifier": "200029611",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE EMRI",
            "identifier": "G8854590",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "0117250",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE POSM",
            "identifier": "G8861208",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.