Peter Michael Vincent, D.P.M

Primary specialty

Sports Medicine PodiatristTaxonomy code 213ES0000X

License

PO00000750 Issued in WA

Practice address

12911 120TH Ave NE Ste C50
Kirkland, WA 98034-3080

Phone

(425) 899-3234

Fax

(425) 899-3235

NPI assigned

Jan 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Aug 18, 2025 through Aug 18, 2027

Specialty

Podiatry

Education

California School of Podiatric Medicine, 1999

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: peter.vincent.1@30681.direct.athenahealth.com

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1982683322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12911 120TH AVE NE STE C50",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343080",
            "telephone_number": "425-899-3234",
            "fax_number": "425-899-3235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12911 120TH AVE NE STE C50",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343080",
            "telephone_number": "425-899-3234",
            "fax_number": "425-899-3235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCENT",
        "first_name": "PETER",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.P.M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "WA",
            "license": "PO000000750",
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "WA",
            "license": "PO00000750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elisa Vila, RPH
• Laarni Villanueva, LMFTA
• Avani Vimawala
• Eileen Vincent, LMP
• Kim Vincent
• Vinette Zabriskie MD PLLC
• Virginia Mason Medical Center
• Marie Mar Visitacion
• Vital Enerqi, PLLC (Eastside Acupuncture & Integrative Medicine)
• Natasha Vlach, MA, LMHC

• Podiatrist in Kirkland, WA
• Providers in Kirkland, WA by specialty
• Podiatrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.