Individual provider Active NPI

Brooke Frances Bekkedahl, PA-C

  • Surgical Physician Assistant
  • Bellevue, WA
National Provider Identifier
1982135570
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA60762133 Issued in WA
Practice address
1231 116TH Ave NE Ste 750
Bellevue, WA 98004-3812
Phone
(425) 455-3600
Fax
(425) 455-3920
NPI assigned
Mar 24, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA60762133 WA Primary

Addresses

Primary practice location

1231 116TH Ave NE Ste 750
Bellevue, WA 98004-3812

Mailing address

805 Madison St Ste 901
Seattle, WA 98104-1172
Phone (206) 264-8100

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
I20170809003695 WA Practitioner - Physician Assistant 6608147608 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA60762133WAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Overlake Medical Clinics, LLC CurrentSince Jan 25, 2020 Accepting new patients
King County Public Hospital District No. 2 CurrentSince Jun 3, 2020 Accepting new patients
King County Public Hospital District No 2 CurrentSince Jun 3, 2020 Accepting new patients

Locations

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

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

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.

NPI Registry JSON

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

{
    "created_epoch": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1982135570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 MADISON ST STE 901",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981041172",
            "telephone_number": "206-264-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 116TH AVE NE STE 750",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043812",
            "telephone_number": "425-455-3600",
            "fax_number": "425-455-3920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEKKEDAHL",
        "first_name": "BROOKE",
        "middle_name": "FRANCES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-24",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA60762133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.