Individual provider Active NPI

Kaylee Deen-Zak Bingham, PA-C

  • Physician Assistant
  • Port Orchard, WA
National Provider Identifier
1992488118
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
61614976 Issued in WA
Practice address
463 Tremont St W Ste 200
Port Orchard, WA 98366-3743
Phone
(360) 876-2434
NPI assigned
Aug 14, 2023
Last updated
Aug 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 61614976 WA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

463 Tremont St W Ste 200
Port Orchard, WA 98366-3743

Mailing address

463 Tremont St W Ste 200
Port Orchard, WA 98366-3743
Phone (360) 876-2434

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
I20241125001062 WA Practitioner - Physician Assistant 9638604887 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Physician Assistant

State licenses

LicenseStateTypeSpecialty
61614976WAMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: kaylee.zak.1@19590.direct.athenahealth.com

Organizations & group practices 1

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": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756425600000",
    "number": "1992488118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "463 TREMONT ST W STE 200",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663743",
            "telephone_number": "360-876-2434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "463 TREMONT ST W STE 200",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983663743",
            "telephone_number": "360-876-2434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BINGHAM",
        "first_name": "KAYLEE",
        "middle_name": "DEEN-ZAK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-14",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "61614976",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orchard, WA

Sources for this page

Verify at the official NPI Registry.