PRATIMA J SHARMA MD
NPI 1164591889
Internal Medicine in Kirkland, WA

Active since November 07, 2006PECOS EnrolledAccepts Medicare Assignment
93.82/100
CMS Quality Rating
12333 NE 130TH LN, STE 310, KIRKLAND, WA 98034(425) 899-6700(425) 899-6701 Get Directions Write a Review

NPPES record last updated: December 18, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Pratima J Sharma Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRATIMA J SHARMA MD (NPI 1164591889) is an individual internal medicine provider in Kirkland, Washington, licensed in Washington (MD00039053) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS, is affiliated with Overlake Hospital Medical Center, and is a graduate of Other (1992).

NPPES Registry Identity

NPI1164591889
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NamePRATIMA J SHARMACredential: MD
Location Address12333 NE 130TH LN, STE 310Kirkland, WA 98034
Mailing AddressPo Box 110456, Ms 13739Tacoma, WA 98411-0456
Fax(425) 899-6701
Sole ProprietorNo
Medical School CMSOtherGraduated 1992
Enumeration DateNovember 7, 2006
Last NPPES UpdateDecember 18, 2007
NPI 1164591889 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License Licensed in WA · MD00039053
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
12333 NE 130TH LN, Kirkland, WA 98034

Other Identifiers 4

Other147279WA · Labor & Industry
Medicare PINGAB22613WA
Other2927SHWA · Regence Health
Medicare UPINH39941

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Pratima J Sharma Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6507842861
PECOS Enrollment IDI20040628000178
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
140 services98 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
64 services64 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
59 services43 patients
Assessment of emotional or behavioral problems 96127
Assessment of emotional or behavioral problems involves a thorough evaluation of your feelings, thoughts, and behaviors. It's a process where professionals study patterns over time to identify potential issues like anxiety, depression, or other mental health conditions.
42 services17 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Overlake Hospital Medical Center

Acute Care Hospitals · Bellevue, WA
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number500051
Location1035-116th Ave NEBellevue, WA 98004 · King County
Emergency services Birthing friendly

Evergreenhealth Monroe

Acute Care Hospitals · Monroe, WA
OwnershipGovernment - Hospital District or Authority
CMS Certification Number500084
Location14701 179th Ave SEMonroe, WA 98272 · Snohomish County
Emergency services

Evergreenhealth Medical Center

Acute Care Hospitals · Kirkland, WA
5/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number500124
Location12040 NE 128th StreetKirkland, WA 98034 · King County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98034 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$143.76 typical visit price
range $63.67 – $189.37
Typical copayment $35.94 (range $15.91 – $47.34)
Most-billed visit code 99204
Established Patient
$111.00 typical visit price
range $21.12 – $155.00
Typical copayment $27.75 (range $5.28 – $38.75)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

93.82/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality100
Promoting Interoperability100
Improvement Activities40
Cost79.41

Reported Quality Measures

Adult Major Depressive Disorder (MDD): Suicide Risk Assessment
0%91 patients
Appropriate Treatment for Upper Respiratory Infection (URI)
100%30 patients5/55-star benchmark: 100%
Breast Cancer Screening
91%227 patients4/55-star benchmark: 93%
Cervical Cancer Screening
59%241 patients3/55-star benchmark: 98%
Closing the Referral Loop: Receipt of Specialist Report
0%297 patients1/55-star benchmark: 87%
Colorectal Cancer Screening
72%367 patients4/55-star benchmark: 88%
Controlling High Blood Pressure
83%194 patients4/55-star benchmark: 91%
Diabetes: Eye Exam
24%50 patients1/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
8%50 patients5/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
98%1,015 patients4/55-star benchmark: 100%
e-Prescribing
100%188 patients5/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
26%237 patients2/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
48%554 patients2/55-star benchmark: 98%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
63%392 patients3/55-star benchmark: 97%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
63%511 patients5/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients screened: 99% · 465 patients
98%465 patients
Provide Patients Electronic Access to Their Health Information
100%201 patients5/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
84%179 patients4/55-star benchmark: 91%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 6% · 243 patients
Patients totalRate: 12% · 243 patients
12%243 patients3/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
5 suppliers17 claims29 services$5.41 avg. paid by Medicare
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357
DME-Orthotic Devices · category DF000N
1 supplier11 claims22 services$8.52 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Genetic Counselor, MS
12333 NE 130TH LN, TAN 240
KIRKLAND, WA 98034
Surgery
12333 NE 130TH LN, SUITE 420
KIRKLAND, WA 98034
Physician Assistant (Surgical)
12333 NE 130TH LN, SUITE 420
KIRKLAND, WA 98034
Clinic/Center (Ambulatory Surgical)
12333 NE 130TH LN, #420
KIRKLAND, WA 98034
Audiologist
12333 NE 130TH LN
KIRKLAND, WA 98034
Nurse Practitioner
12333 NE 130TH LN, #302
KIRKLAND, WA 98034
Dermatology
12333 NE 130TH LN, SUITE 330
KIRKLAND, WA 98034
Internal Medicine (Pulmonary Disease)
12333 NE 130TH LN, SUITE 225
KIRKLAND, WA 98034

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pratima Sharma's NPI number?

The NPI number for Pratima Sharma is 1164591889. It was assigned to this individual provider in the NPPES registry on November 7, 2006.

Where is Pratima Sharma located?

Pratima Sharma practices at 12333 NE 130th Ln Ste 310, Kirkland, WA 98034. The listed phone number is (425) 899-6700.

What is Pratima Sharma's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Pratima Sharma enrolled in Medicare?

Yes. Pratima Sharma is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Pratima Sharma accept?

Health plans from PacificSource Health Plans, Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Pratima Sharma as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Pratima Sharma affiliated with any hospitals?

According to CMS data, Pratima Sharma is affiliated with Overlake Hospital Medical Center, Evergreenhealth Monroe and Evergreenhealth Medical Center.

When was this NPI record last updated?

The NPPES record for Pratima Sharma was last updated on December 18, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.