Kenneth John Hebert, MD

Primary specialty

Neuroradiology PhysicianTaxonomy code 2085N0700X

License

MD60627720 Issued in WA

Practice address

19020 33Rd Ave W Ste 210
Lynnwood, WA 98036-4748

Phone

(425) 563-1500

Fax

(425) 563-1501

NPI assigned

May 25, 2007

Last updated

Mar 5, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA, WA, TX3 enrollments

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 3

Specialty

Diagnostic Radiology

Education

Louisiana State University School of Medicine in New Orleans, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Radiology Associates PAGroup PAC ID 7517953912, 103 clinicians

Evergreen Radia LLCGroup PAC ID 4587568076, 116 clinicians

Central Washington Health Services AssociationGroup PAC ID 4880504596, 708 clinicians

Medford Radiological Group PCGroup PAC ID 2062303324, 91 clinicians

Radia Oregon Radiology Medical Group LLCGroup PAC ID 2961852637, 122 clinicians

Swedish Health ServicesGroup PAC ID 3173433067, 156 clinicians

Radia Inc P SGroup PAC ID 9931012812, 275 clinicians

Swedish Radia Imaging Center at Edmonds LLCGroup PAC ID 5496778292, 115 clinicians

Yakima Valley Memorial PhysiciansGroup PAC ID 1557391596, 397 clinicians

Okanogan County Public Hospital District No. 3Group PAC ID 6800707951, 89 clinicians

Public Hospital District No 4 King County WashingtonGroup PAC ID 6002700861, 85 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018
• Yakima Valley Memorial Hospital, Yakima, WA, CCN 500036
• Overlake Hospital Medical Center & Clinics Hospital, Bellevue, WA, CCN 500051
• Peacehealth Southwest Medical Cente Hospital, Vancouver, WA, CCN 500050
• Banner Gateway Medical Center Hospital, Gilbert, AZ, CCN 030122

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 30)

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Central Washington Health Services Association

  dba Confluence Health

  • Emergency Medical Services (Emergency Medicine) Physician
  • Wenatchee, WA
  • NPI 1801937453
  Medicare reassignment Care Compare group NPD
• Evergreen Radia LLC

  dba Evergreen Radia

  • Diagnostic Radiology Physician
  • Kirkland, WA
  • NPI 1922095694
  Medicare reassignment Care Compare group NPD
• Okanogan County Public Hospital District No. 3

  dba Mid-Valley Hospital

  • Critical Access Hospital
  • Omak, WA
  • NPI 1255387403
  Medicare reassignment Care Compare group NPD
• Public Hospital District No 4 King County Washington

  dba Snoqualmie Valley Hospital

  • Critical Access Hospital
  • Snoqualmie, WA
  • NPI 1902846546
  Medicare reassignment Care Compare group NPD
• Radia Inc P S

  dba Radia

  • Diagnostic Radiology Physician
  • Lynnwood, WA
  • NPI 1932196607

  GA

  Medicare reassignment Care Compare group NPD
• Swedish Health Services

  dba Swedish Imaging Clinics

  • Body Imaging Physician
  • Everett, WA
  • NPI 1114356904
  Medicare reassignment Care Compare group NPD
• Swedish Radia Imaging Center at Edmonds LLC

  dba Swedish Radia Edmonds

  • Diagnostic Radiology Physician
  • Edmonds, WA
  • NPI 1164494373
  Medicare reassignment Care Compare group NPD
• Yakima Valley Memorial Physicians

  • General Acute Care Hospital
  • Yakima, WA
  • NPI 1306933940
  Medicare reassignment Care Compare group NPD
• Medford Radiological Group, PC

  • Diagnostic Radiology Physician
  • Medford, OR
  • NPI 1407938111

  WA

  Medicare reassignment Care Compare group NPD
• Radia Oregon Radiology Medical Group LLC

  dba Radia Oregon

  • Diagnostic Radiology Physician
  • Medford, OR
  • NPI 1073385423

  GA, WA

  Medicare reassignment Care Compare group NPD
• Radiology Associates PA

  • Diagnostic Radiology Physician
  • Little Rock, AR
  • NPI 1366438186

  WA

  Medicare reassignment Care Compare group NPD
• Central Washington Health Services Association

  dba Confluence Health

  • General Acute Care Hospital
  • Wenatchee, WA
  • NPI 1881642239

  GA

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Overlake Medical Center & Clinics

  • General Acute Care Hospital
  • Bellevue, WA
  • NPI 1598971855
  Care Compare affiliation
• Overlake Medical Center & Clinics

  • General Acute Care Hospital
  • Bellevue, WA
  • NPI 1861432726
  Care Compare affiliation
• Peacehealth

  dba PeaceHealth SW Heart & Vascular Center

  • Cardiovascular Disease Physician
  • Vancouver, WA
  • NPI 1003194911

  Hospital

  Care Compare affiliation
• Peacehealth

  dba PeaceHealth Southwest Medical Center

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1134178999
  Care Compare affiliation
• Yakima Valley Memorial Hospital Association

  dba MultiCare Yakima Memorial Hospital

  • General Acute Care Hospital
  • Yakima, WA
  • NPI 1053373480
  Care Compare affiliation
• Asante

  dba Asante Rogue Regional Medical Center

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1770587107
  Care Compare affiliation
• Banner Gateway Medical Center

  • General Acute Care Hospital
  • Gilbert, AZ
  • NPI 1699884858
  Care Compare affiliation

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520208000000",
    "number": "1982815296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19020 33RD AVE W STE 210",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364748",
            "telephone_number": "425-563-1500",
            "fax_number": "425-563-1501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19020 33RD AVE W STE 210",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364748",
            "telephone_number": "425-563-1500",
            "fax_number": "425-563-1501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEBERT",
        "first_name": "KENNETH",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-25",
        "last_updated": "2018-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD60627720",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "57010492",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "P8912",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "WA",
            "license": "MD60627720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2056898",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Healthy Infusion at Amy's (Naturopathic Infusion at Dr. Amy's)
• Healthy Massage
• Healthy Toez, LLC
• Jamie Heathman, PHARMD
• Bambi E Heaton, LMP
• Michel Hebert, LMP
• Michael Phoenix Jay Hefferan
• Benjamin Heinbaugh
• Stephen Heins
• Amy Helgoe

• Neuroradiology Physician in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• Neuroradiology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2018; 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.
• 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.