MASAKO KOMIYAMA LICSW, ARNP
NPI 1790113413
Nurse Practitioner - Psychiatric/Mental Health in Seattle, WA

Q: What is Masako Komiyama's NPI number?

The NPI number for Masako Komiyama is 1790113413. It was assigned to this individual provider in the NPPES registry on October 15, 2013.

Q: What is Masako Komiyama's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Masako Komiyama was last updated on October 10, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.

Active since October 15, 2013PECOS Enrolled

3639 MARTIN LUTHER KING JR WAY S, SEATTLE, WA 98144(206) 695-7600(206) 695-7606 Get Directions Write a Review

NPPES record last updated: October 10, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 10, 2019, Nov 30, 2018 (2 updates tracked since 2018).

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About Masako Komiyama Licsw, Arnp NPPES

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

MASAKO KOMIYAMA LICSW, ARNP (NPI 1790113413) is an individual psychiatric/mental health provider in Seattle, Washington, licensed in Washington (AP60994940) and active in the NPI registry since October 2013. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1790113413

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameMASAKO KOMIYAMACredential: LICSW, ARNP

Location Address3639 MARTIN LUTHER KING JR WAY SSeattle, WA 98144

Mailing Address3639 Martin Luther King Jr Way SSeattle, WA 98144-6847 · (206) 695-7600 · Fax (206) 695-7606

Phone(206) 695-7600

Fax(206) 695-7606

Sole ProprietorNo

Enumeration DateOctober 15, 2013

Last NPPES UpdateOctober 10, 20192 updates tracked since enumeration

✔ NPI 1790113413 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in WA · AP60994940

Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X · License 743080021 (WA)

3639 MARTIN LUTHER KING JR WAY S, Seattle, WA 98144

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Secondary Practice Locations 2

Location 12600 SW Holden StSeattle, WA 98126-3505 · Phone (206) 248-8226

Location 210212 5th Ave NE Ste 150Seattle, WA 98125-7473 · Phone (206) 418-0600 · Fax (206) 418-0612

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Masako Komiyama Licsw, Arnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Masako Komiyama reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Asian Counseling And Referral Service

0.1 mi

Mental Health (Including Community Mental Health Center)

3639 MARTIN LUTHER KING JR. WAY SOUTH
Seattle, WA 98144

Reassigned Medicare billing, Washington enrollment
18 clinicians in this Medicare group

NPI 1962507442 (206) 695-7600

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98144 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$97.43 typical visit price

range $63.67 – $189.37

Typical copayment $24.35 (range $15.91 – $47.34)

Most-billed visit code 99203

Established Patient

$111.00 typical visit price

range $21.12 – $155.00

Typical copayment $27.75 (range $5.28 – $38.75)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KAIWEN TAN LICSW

Social Worker