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MAKSPORTSMD
NPI 1417469404
Family Medicine - Sports Medicine in Bothell, WA

Active since October 30, 2017
19110 BOTHELL WAY NE STE 102, BOTHELL, WA 98011(425) 286-8271(425) 491-7271 Get Directions Write a Review

NPPES record last updated: October 30, 2017. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Maksportsmd NPPES

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

MAKSPORTSMD (NPI 1417469404) is a healthcare organization registered as a sports medicine in Bothell, Washington and active in the NPI registry since October 2017. The organization lists Abimbolu Makinde, Owner, as its authorized official.

NPPES Registry Identity

NPI1417469404
Entity TypeOrganization
Primary Taxonomy207QS0010X
Legal Business NameMAKSPORTSMD
Location Address19110 BOTHELL WAY NE STE 102Bothell, WA 98011-2970
Mailing Address19110 Bothell Way Ne Ste 102Bothell, WA 98011-2970
Phone(425) 286-8271
Fax(425) 491-7271
Organization SubpartNo
Authorized OfficialAbimbolu MakindeOwner · (425) 286-8271
Enumeration DateOctober 30, 2017
✔ NPI 1417469404 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QS0010X
License✔ Licensed in WA · 60465979
Definition
A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
19110 BOTHELL WAY NE STE 102, Bothell, WA 98011
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Premera Blue Cross Blue Shield of Alaska.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Maksportsmd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

4

Medicare enrollment records show 4 clinicians reassign Medicare billing to Maksportsmd, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (4)

Abimbolu Makinde, M.D.
Sports Medicine
NPI 1669769337
19110 BOTHELL WAY NE STE 102
Bothell, WA 98011
(425) 286-8271
✔ PECOS✔ Accepts MedicareSame address
Yanqun Bu
Nurse Practitioner
NPI 1457697526
1303 PACIFIC AVE
Everett, WA 98201
(425) 339-5476
✔ PECOS✔ Accepts Medicare15 mi
Amanda Macklin, ARNP
Nurse Practitioner
NPI 1740707967
630 N FAIRVIEW DR # 256
Tacoma, WA 98406
(253) 777-1423
✔ PECOS✔ Accepts Medicare38 mi
Jessica Taylor, ARNP-C
Nurse Practitioner
NPI 1851069538
MADIAGN ARMY MEDICAL CENTER 9040 JACKSON AVENUE
Tacoma, WA 98431
(865) 567-3530
✔ PECOS✔ Accepts Medicare48 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Maksportsmd's NPI number?

The NPI number for Maksportsmd is 1417469404. It was assigned to this organization in the NPPES registry on October 30, 2017.

Where is Maksportsmd located?

Maksportsmd is located at 19110 Bothell Way NE Ste 102, Bothell, WA 98011. The listed phone number is (425) 286-8271.

What is Maksportsmd's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Is Maksportsmd enrolled in Medicare?

Yes. Maksportsmd is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Maksportsmd?

According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians in 2 Medicare specialties reassign their Medicare billing to Maksportsmd. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (3) and Sports Medicine (1). Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Maksportsmd accept?

Health plans from Ambetter Health and Premera Blue Cross Blue Shield of Alaska list Maksportsmd 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.

When was this NPI record last updated?

The NPPES record for Maksportsmd was last updated on October 30, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.