N/A
NPI 1699364455
Family Medicine in Federal Way, WA
About N/a NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
N/A (NPI 1699364455) is a healthcare organization registered as a family medicine in Federal Way, Washington and active in the NPI registry since January 2021. The organization holds a CLIA Waiver certificate valid through April 4, 2028, maintains 2 additional practice locations, and lists Kristyn Dice, Contracting Manager, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Secondary Practice Locations 2
Group Practice 1
Accepted 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)
N/a is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
8Medicare enrollment records show 8 clinicians reassign Medicare billing to N/A, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. They are listed nearest first.
Clinicians, nearest first (8)
Cleveland, TN 37312
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 50D2233945
Prudent Medical Providers · Federal Way, 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 Prudent Medical Providers NW's NPI number?
The NPI number for Prudent Medical Providers NW is 1699364455. It was assigned to this organization in the NPPES registry on January 15, 2021.
Where is Prudent Medical Providers NW located?
Prudent Medical Providers NW is located at 1045 S 320th St Ste 7, Federal Way, WA 98003. The listed phone number is (206) 212-6554.
What is Prudent Medical Providers NW's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Prudent Medical Providers NW enrolled in Medicare?
Yes. Prudent Medical Providers NW is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Prudent Medical Providers NW?
According to the CMS Revalidation Reassignment List (October 2026 release), 8 clinicians in 2 Medicare specialties reassign their Medicare billing to Prudent Medical Providers NW. 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 (6) and Family Practice (2). Of these, 1 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Prudent Medical Providers NW hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 50D2233945) 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 Prudent Medical Providers NW accept?
Health plans from Ambetter Health and Premera Blue Cross Blue Shield of Alaska list Prudent Medical Providers NW 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 Prudent Medical Providers NW was last updated on July 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# N/a · NPI 1699364455
Family Medicine organization in Federal Way, Washington. Organization record, active in the CMS NPPES registry since January 15, 2021.
## Identity
- **NPI:** 1699364455 (Entity type: Organization)
- **Enumerated:** January 15, 2021
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Prudent Medical Providers Nw
- **Organization subpart:** No
- **Authorized official:** Kristyn Dice, CONTRACTING MANAGER
## Practice location
- **Address:** 1045 S 320TH ST STE 7, Federal Way, WA 98003-5179
- **Phone:** (206) 212-6554
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 8 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (6), Family Practice (2); 1 practice at this address and 3 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 13, 2023
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1699364455) · Data from the CMS NPPES public registry.