KEY BRIDGE MEDICAL CLINIC LLC
NPI 1679178099
Clinic/Center - Primary Care in Lakewood, WA
About Key Bridge Medical Clinic Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KEY BRIDGE MEDICAL CLINIC LLC (NPI 1679178099) is a healthcare organization registered as a primary care in Lakewood, Washington and active in the NPI registry since December 2020. The organization lists Kerbie Salvador A Barrantes, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
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)
Key Bridge Medical Clinic Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by October 31, 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
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Key Bridge Medical Clinic LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.
Clinicians, nearest first (3)
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 Key Bridge Medical Clinic LLC's NPI number?
The NPI number for Key Bridge Medical Clinic LLC is 1679178099. It was assigned to this organization in the NPPES registry on December 2, 2020.
Where is Key Bridge Medical Clinic LLC located?
Key Bridge Medical Clinic LLC is located at 11318 Bridgeport Way SW Ste A, Lakewood, WA 98499. The listed phone number is (253) 533-3838.
What is Key Bridge Medical Clinic LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.
Is Key Bridge Medical Clinic LLC enrolled in Medicare?
Yes. Key Bridge Medical Clinic LLC is registered in the Medicare PECOS enrollment system.
When is Key Bridge Medical Clinic LLC'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 October 31, 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 Key Bridge Medical Clinic LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Key Bridge Medical Clinic LLC. 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. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Key Bridge Medical Clinic LLC was last updated on January 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Key Bridge Medical Clinic Llc · NPI 1679178099
Primary Care organization in Lakewood, Washington. Organization record, active in the CMS NPPES registry since December 2, 2020.
## Identity
- **NPI:** 1679178099 (Entity type: Organization)
- **Enumerated:** December 2, 2020
- **Primary specialty:** Clinic/Center - Primary Care · taxonomy 261QP2300X
- **Organization subpart:** No
- **Authorized official:** Kerbie Salvador Barrantes, OWNER
## Practice location
- **Address:** 11318 BRIDGEPORT WAY SW STE A, Lakewood, WA 98499-3054
- **Phone:** (253) 533-3838
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** October 31, 2026 (Non-DME Part B, Washington, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 3 clinicians (Nurse Practitioner) reassign Medicare billing to this organization (form CMS-855R); 1 practice at this address and 2 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 28, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1679178099) · Data from the CMS NPPES public registry.