DR. DONNA J. PEDROZA MBBS, MA
NPI 1376819425
Hospitalist in Seattle, WA

Active since March 22, 2012PECOS EnrolledAccepts Medicare Assignment
93.09/100
CMS Quality Rating
1550 N 115TH ST # MSD149B, SEATTLE, WA 98133(206) 668-1500 Get Directions Write a Review

NPPES record last updated: October 23, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 23, 2019, Apr 27, 2018 (2 updates tracked since 2018).

About Dr. Donna J. Pedroza Mbbs, Ma NPPES

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

DR. DONNA J. PEDROZA MBBS, MA (NPI 1376819425) is an individual hospitalist provider in Seattle, Washington, licensed in Washington (MD60483510) and active in the NPI registry since March 2012. She is enrolled in Medicare PECOS, is affiliated with University Of Washington Medical Ctr, and is a graduate of Other (2009).

NPPES Registry Identity

NPI1376819425
Entity TypeIndividualFemale
Primary Taxonomy208M00000X
Provider Legal NameDR. DONNA J. PEDROZACredential: MBBS, MA
Location Address1550 N 115TH ST # MSD149BSeattle, WA 98133-8498
Mailing AddressPo Box 50095Seattle, WA 98145-5095 · (206) 520-5700
Sole ProprietorNo
Medical School CMSOtherGraduated 2009
Enumeration DateMarch 22, 2012
Last NPPES UpdateOctober 23, 20192 updates tracked since enumeration
NPI 1376819425 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
License Licensed in WA · MD60483510
Definition
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
Also ListedInternal MedicineTaxonomy 207R00000X · License MD60483510 (WA)
1550 N 115TH ST # MSD149B, Seattle, WA 98133

Other Identifiers 1

Medicaid1376819425WA

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

Dr. Donna J. Pedroza Mbbs, Ma 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 ID1355665936
PECOS Enrollment IDI20150618002883
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 5

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.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
226 services78 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
61 services32 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
48 services48 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
41 services40 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
13 services13 patients

Hospital Affiliations CMS Care Compare

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

University Of Washington Medical Ctr

Acute Care Hospitals · Seattle, WA
3/5 CMS rating
OwnershipGovernment - State
CMS Certification Number500008
Location1959 NE Pacific St Box 356151Seattle, WA 98195 · King County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98133 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.

93.09/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality73.95
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES

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

Internal Medicine
1550 N 115TH ST # MSD149B
SEATTLE, WA 98133

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 Donna Pedroza's NPI number?

The NPI number for Donna Pedroza is 1376819425. It was assigned to this individual provider in the NPPES registry on March 22, 2012.

Where is Donna Pedroza located?

Donna Pedroza practices at 1550 N 115th St # Msd149b, Seattle, WA 98133. The listed phone number is (206) 668-1500.

What is Donna Pedroza's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Is Donna Pedroza enrolled in Medicare?

Yes. Donna Pedroza 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 Donna Pedroza accept?

Health plans from Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Donna Pedroza 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 Donna Pedroza affiliated with any hospitals?

According to CMS data, Donna Pedroza is affiliated with University Of Washington Medical Ctr.

When was this NPI record last updated?

The NPPES record for Donna Pedroza was last updated on October 23, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.