EVERGREEN EMERGENCY SERVICES, PS
NPI 1619912524
Emergency Medicine in Kirkland, WA

Q: What is Evergreen Emergency Services, Ps's NPI number?

The NPI number for Evergreen Emergency Services, Ps is 1619912524. It was assigned to this organization in the NPPES registry on June 17, 2006.

Q: What is Evergreen Emergency Services, Ps's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Active since June 17, 2006

12040 NE 128TH ST, KIRKLAND, WA 98034(206) 550-5253 Get Directions Write a Review

NPPES record last updated: November 20, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Evergreen Emergency Services, Ps NPPES

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

EVERGREEN EMERGENCY SERVICES, PS (NPI 1619912524) is a healthcare organization registered as an emergency medicine in Kirkland, Washington and active in the NPI registry since June 2006. The organization lists Chad Crystal, President, as its authorized official.

NPPES Registry Identity

NPI1619912524

Entity TypeOrganization

Primary Taxonomy207P00000X

Legal Business NameEVERGREEN EMERGENCY SERVICES, PS

Location Address12040 NE 128TH STKirkland, WA 98034-3013

Mailing AddressFile 50421Los Angeles, CA 90074-0001 · (855) 691-9890

Phone(206) 550-5253

Organization SubpartNo

Authorized OfficialChad CrystalPresident · (425) 899-1751

Enumeration DateJune 17, 2006

Last NPPES UpdateNovember 20, 2020

NPPES CertifiedNovember 20, 2020

✔ NPI 1619912524 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207P00000X

Definition

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

12040 NE 128TH ST, Kirkland, WA 98034

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Other Identifiers 4

Medicaid7122864WA

Other184567Washington Crime Victims

Other604658700Us Deptarment Of Labor

Other8938298Washington Crime Victims

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include 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)

Evergreen Emergency Services, Ps is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 68 clinicians reassign Medicare billing to Evergreen Emergency Services, Ps, which bills Medicare for the services they deliver. Of these, 10 practice at this address and 19 within 10 miles. Listed here are the 20 practicing nearest to this location.

Nearest to this location (20)

See all 68

Dominic Connolly, M.D.

Emergency Medicine

NPI 1093754269