Individual provider Active NPI

Jonathan Dale Choi, M.D.

  • Neurological Surgery Physician
  • Bellevue, WA
National Provider Identifier
1982862942
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
MD61174359 Issued in WA
Practice address
1135 116TH Ave NE Ste 500
Bellevue, WA 98004-4627
Phone
(425) 635-6560
NPI assigned
May 27, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 62871 MN
Neurological Surgery Physician 207T00000X A129466 CA
Neurological Surgery Physician 207T00000X MD61174359 WA Primary

Addresses

Primary practice location

1135 116TH Ave NE Ste 500
Bellevue, WA 98004-4627

Mailing address

1135 116TH Ave NE Ste 500
Bellevue, WA 98004-4627

Other identifiers 1

IdentifierTypeStateIssuer
MD61174359OtherWAWASHINGTON MEDICAL COMMISSION

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
I20210901003073 WA Practitioner - Neurosurgery 4284867094 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
62871MNMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No 2 Current Accepting new patients
King County Public Hospital District No 2 CurrentSince Sep 1, 2021 Accepting new patients
Overlake Medical Clinics, LLC Current Accepting new patients
Overlake Medical Clinics LLC CurrentSince Sep 27, 2021 Accepting new patients
King County Public Hospital District No. 2 CurrentSince Sep 1, 2021 Accepting new patients
Issaquah Obstetrics and Gynecology PLLC Past Accepting new patients
Montage Surgical Group Neurological Surgery Past Accepting new patients

Locations

1135 116th Ave NE
Ste 500
Bellevue, WA 98004
Phone (425) 454-3938

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

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

6520 226th Pl SE
Ste 150
Issaquah, WA 98027
Phone (425) 688-5777

12040 NE 128th St
Kirkland, WA 98034
Phone (425) 899-1000

12039 NE 128th St
Ste 300
Kirkland, WA 98034
Phone (425) 899-3123

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1982862942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 116TH AVE NE STE 500",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 116TH AVE NE STE 500",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980044627",
            "telephone_number": "425-635-6560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOI",
        "first_name": "JONATHAN",
        "middle_name": "DALE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-27",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MN",
            "license": "62871",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CA",
            "license": "A129466",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "WA",
            "license": "MD61174359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHINGTON MEDICAL COMMISSION",
            "identifier": "MD61174359",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.