Individual provider Active NPI

Alisa Christine Van Cleave, M.D.

  • Pediatric Critical Care Medicine Physician
  • Seattle, WA
National Provider Identifier
1972790715
Registry record updated Jun 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
MD60356821 Issued in WA
Practice address
4800 Sand Point Way NE
M/S MB 10.620
Seattle, WA 98105-3901
Phone
(206) 987-2170
NPI assigned
Sep 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X MD60356821 WA Primary
Pediatric Hospice and Palliative Medicine Physician 2080H0002X MD60356821 WA
Pediatrics Physician 208000000X MD60356821 WA

Addresses

Primary practice location

4800 Sand Point Way NE
M/S MB 10.620
Seattle, WA 98105-3901

Mailing address

4800 Sand Point Way NE
M/S MB 10.620
Seattle, WA 98105-3901
Phone (206) 987-2170

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
I20140922002669 WA Practitioner - Pediatric MedicinePractitioner - Critical Care (Intensivists) 4385863430 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60356821WAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Association of CHMC and University Physicians Pediatrics CurrentSince Jul 6, 2014 Accepting new patients
The Association of Chrmc and University Physicians Pediatrics CurrentSince Jul 6, 2014 Accepting new patients
Seattle Children'S Hospital Past Accepting new patients

Locations

900 Pacific Ave
Ste 100
Everett, WA 98201
Phone (425) 304-6080

4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000

4800 Sand Point Way NE
#10620
Seattle, WA 98105
Phone (206) 987-0293

Interoperability endpoints

  • Direct secure messaging: avancleave22285@direct.seattlechildrens.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403049600000",
    "number": "1972790715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 SAND POINT WAY NE",
            "address_2": "M/S MB 10.620",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981053901",
            "telephone_number": "206-987-2170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 SAND POINT WAY NE",
            "address_2": "M/S MB 10.620",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981053901",
            "telephone_number": "206-987-2170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN CLEAVE",
        "first_name": "ALISA",
        "middle_name": "CHRISTINE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-25",
        "last_updated": "2014-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "WA",
            "license": "MD60356821",
            "primary": true
        },
        {
            "code": "2080H0002X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Hospice and Palliative Medicine",
            "state": "WA",
            "license": "MD60356821",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD60356821",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.