OVERLAKE IMAGING ASSOCIATES PC (NPI# 1902870827) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902870827 |
| Entity Type | Organization |
| Organization Name | OVERLAKE IMAGING ASSOCIATES PC |
| Practice Address |
1417 116th Ave Ne Ste 212 Bellevue WA 98004-3821 |
| Mailing Address |
Po Box 24226 Seattle WA 98124-0226 |
| Practice Telephone | 4255028362 |
| Mailing Telephone | 8775561057 |
| Mailing Fax Number | 8005084751 |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2013-03-06 |
| Authorized Official Name | MARK J PFLEGER (PRESIDENT) |
| Authorized Official Telephone | 4255028362 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
WA | Allopathic & Osteopathic Physicians | |
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | L&I | 109450 | 01 |
| RAILROAD MEDICARE | CD3333 | 01 | |
| WA | 7078454 | 05 |
| Street Address |
1417 116TH AVE NE STE 212 |
| City | BELLEVUE |
| State | WA |
| Zip Code | 98004-3821 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306458328 | Geneva Paula Hoskins-dorsey | Nurse Practitioner | 11120 Ne 33rd Place, Suite 202, Bellevue, WA 98004 | 2020-08-20 |
| 1720553613 | Christine Eyler | Pediatrics | Bellevue Pediatrics, C & C Medical Associates, 1940 116th Ave Ne, Ste 200, Bellevue, WA 98004 | 2018-10-08 |
| 1437634730 | Hazelden Betty Ford Foundation | Clinic/Center | 1231 116th Ave. Ne Suite 410, Bellevue, WA 98004 | 2018-10-02 |
| 1356827828 | Seattle Spine Group, Pllc | Orthopaedic Surgery | 1220 116th Ave Ne Ste 102, Bellevue, WA 98004 | 2018-07-17 |
| 1669989216 | Atsuko Nakajima | Acupuncturist | 2223 112th Ave. Ne, Ste 201, Bellevue, WA 98004 | 2018-01-04 |
| 1740794718 | Radka Chapin Counseling, LLC | Clinic/Center | 1611 116th Ave Ne Ste 119, Bellevue, WA 98004 | 2017-11-28 |
| 1962912105 | Cuyler Ann Simmons | Counselor | 3805 108th Ave Ne Ste 204, Bellevue, WA 98004 | 2017-10-02 |
| 1639690357 | Nicolas Lopez-montalvo | Behavioral Analyst | 3003 Northup Way Suite 200, Bellevue, WA 98004 | 2017-07-03 |
| 1124579537 | Matthew Thomas Haley | Pharmacist | 107 Bellevue Way, Se, Bellevue, WA 98004 | 2016-10-20 |
| 1649727348 | Kelsey Tanaka | Nurse Practitioner | 400- 108th Ave Ne, Suite 100, Bellevue, WA 98004 | 2016-09-10 |
| Find all providers in zip 98004 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164845202 | Diagnostic Radiology Bellevue Office | Radiology | 2510 Bellevue Medical Center Dr Ste 145, Bellevue, NE 68123-1556 | 2014-01-26 |
| 1932202330 | Brian Coate Jacobs | Radiology | 1400 116th Ave Ne, Bellevue, WA 98004 | 2006-09-07 |
| 1033170279 | South Shore Radiology Inc | Radiology | 1400 Main Street, Bellevue, OH 44811-1028 | 2006-03-29 |
| 1720442932 | Swedish Health Services | Radiology | 1200 112th Ave Ne, Suite B250, Bellevue, WA 98004-3732 | 2016-04-13 |
| 1811138589 | South Shore Imaging Inc | Radiology | 1400 W Main St, Bellevue, OH 44811-9088 | 2009-03-10 |
| 1518142124 | Gregory Thomas Peters | Radiology | 2500 Bellevue Medical Center Dr, Bellevue, NE 68123-1591 | 2008-01-02 |
| 1114144417 | Christopher Troy Koch | Radiology | 2500 Bellevue Medical Center Dr, Bellevue, NE 68123-1591 | 2007-04-19 |
| 1255484283 | Jason William Burns | Radiology | 11511 Ne 10th St, Bellevue, WA 98004-8578 | 2007-01-21 |
| 1255423331 | Andrew D. Bronstein | Radiology | 1310 116th Ave Ne, Suite E, Bellevue, WA 98004-3817 | 2006-09-28 |
| 1043302136 | Calixto T. Dimas | Radiology | 1310 116th Ave Ne, Suite E, Bellevue, WA 98004-3817 | 2006-09-28 |
| Find all providers in BELLEVUE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.