EDMONDS HEALTH CLINIC
NPI 1649553538
Family Medicine in Edmonds, WA
About Edmonds Health Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EDMONDS HEALTH CLINIC (NPI 1649553538) is a healthcare organization registered as a family medicine in Edmonds, Washington and active in the NPI registry since September 2011. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Ella Yepraksia Bostanjian, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Edmonds Health Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by November 30, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Edmonds Health Clinic, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 50D2048226
Edmonds Health Clinic · Edmonds, WAFrequently 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 Edmonds Health Clinic's NPI number?
The NPI number for Edmonds Health Clinic is 1649553538. It was assigned to this organization in the NPPES registry on September 27, 2011.
Where is Edmonds Health Clinic located?
Edmonds Health Clinic is located at 617 5th Ave S, Edmonds, WA 98020. The listed phone number is (425) 697-2100.
What is Edmonds Health Clinic's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Edmonds Health Clinic enrolled in Medicare?
Yes. Edmonds Health Clinic is registered in the Medicare PECOS enrollment system.
When is Edmonds Health Clinic's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Washington, Clinic/Group Practice) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Edmonds Health Clinic?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (General Practice) reassigns their Medicare billing to Edmonds Health Clinic. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Edmonds Health Clinic hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 50D2048226) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Edmonds Health Clinic accept?
Health plans from Premera Blue Cross Blue Shield of Alaska list Edmonds Health Clinic 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 Edmonds Health Clinic was last updated on September 27, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.
# Edmonds Health Clinic · NPI 1649553538
Family Medicine organization in Edmonds, Washington. Organization record, active in the CMS NPPES registry since September 27, 2011.
## Identity
- **NPI:** 1649553538 (Entity type: Organization)
- **Enumerated:** September 27, 2011
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Ella Bostanjian, OWNER
## Practice location
- **Address:** 617 5TH AVE S, Edmonds, WA 98020-3452
- **Phone:** (425) 697-2100 · **Fax:** (425) 697-5556
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** November 30, 2026 (Non-DME Part B, Washington, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 1 clinician (General Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 27, 2011
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1649553538) · Data from the CMS NPPES public registry.