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OVERLAKE MEDICAL CLINICS LLC
NPI 1871745703
Specialist in Bellevue, WA

Active since October 22, 2008CLIA 50D1030619 · Certificate of Compliance
1750 112TH AVE NE, SUITE A101, BELLEVUE, WA 98004(425) 688-5234(425) 688-5756 Get Directions Write a Review

NPPES record last updated: October 22, 2008. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Overlake Medical Clinics Llc NPPES

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

OVERLAKE MEDICAL CLINICS LLC (NPI 1871745703) is a healthcare organization registered as a specialist in Bellevue, Washington and active in the NPI registry since October 2008. The organization holds a CLIA Certificate of Compliance certificate valid through April 4, 2028 and lists David Schultz, Coo, as its authorized official.

NPPES Registry Identity

NPI1871745703
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameOVERLAKE MEDICAL CLINICS LLC
Location Address1750 112TH AVE NE, SUITE A101Bellevue, WA 98004-3752
Mailing AddressPo Box 3905, Dept 4204Seattle, WA 98124-3905 · (425) 688-5777 · Fax (425) 688-5605
Phone(425) 688-5234
Fax(425) 688-5756
Organization SubpartYes
Authorized OfficialDavid SchultzCoo · (425) 688-5470
Enumeration DateOctober 22, 2008
✔ NPI 1871745703 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
1750 112TH AVE NE, Bellevue, WA 98004
Open in Google Maps ↗

Other Identifiers 1

Medicare PINGAB06825WA

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)

Overlake Medical Clinics Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

562

Medicare enrollment records show 562 clinicians reassign Medicare billing to Overlake Medical Clinics LLC, which bills Medicare for the services they deliver. Of these, 9 practice at this address and 386 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 46

Nurse Practitioner98
Family Practice89
Internal Medicine63
Neurology42
Obstetrics/Gynecology31
Physical Therapist in Private Practice31
Emergency Medicine21
Psychiatry21
38 other specialties166

Nearest to this location (20)

See all 562
Priyanka Duggal, MD
Geriatric Medicine
NPI 1710189253
1750 112TH AVE NE SUITE A101
Bellevue, WA 98004
(206) 598-5500
✔ PECOS✔ Accepts MedicareSame address
William Pierson, M.D.
Psychiatry
NPI 1528357001
1750 112TH AVE NE SUITE B102
Bellevue, WA 98004
(425) 688-5460
✔ PECOS✔ Accepts MedicareSame address
Daisy Wan, RD
Registered Dietitian or Nutrition Professional
NPI 1366976656
1750 112TH AVE NE BLDG 4 STE E175
Bellevue, WA 98004
(425) 289-0381
✔ Accepts MedicareSame address
Tasheena Carlson
Mental Health Counselor
NPI 1073142360
1750 112TH AVE NE STE B102
Bellevue, WA 98004
(425) 688-5460
✔ PECOS✔ Accepts MedicareSame address
Llewellyn Packia Raj, MD
Physical Medicine and Rehabilitation
NPI 1659339695
1750 112TH AVE NE STE D258
Bellevue, WA 98004
(425) 498-2272
✔ PECOS✔ Accepts MedicareSame address
Worawan Rattanasamphan, MD
Geriatric Medicine
NPI 1073574471
1750 112TH AVE NE SUITE A-101
Bellevue, WA 98004
(425) 688-5234
✔ PECOS✔ Accepts MedicareSame address
Tianyue Zhao, RD
Registered Dietitian or Nutrition Professional
NPI 1841967080
1750 112TH AVE NE STE A101
Bellevue, WA 98004
(425) 688-5846
✔ Accepts MedicareSame address
Rebecca Hildreth, DNP
Nurse Practitioner
NPI 1942188826
1750 112TH AVE NE STE A101
Bellevue, WA 98004
(425) 688-5234
✔ PECOS✔ Accepts MedicareSame address
Aishwarya Prasad, MD, MPH
Psychiatry
NPI 1487036828
1750 112TH AVE NE STE B102
Bellevue, WA 98004
(425) 688-5000
✔ PECOS✔ Accepts MedicareSame address
Elisabeth Anton, M. D.
Obstetrics/Gynecology
NPI 1487661211
1535 116TH AVE NE SUITE 100
Bellevue, WA 98004
(425) 455-0244
✔ PECOS✔ Accepts Medicare0.2 mi
Sagira Vora, PT
Physical Therapist in Private Practice
NPI 1932148210
1605 116TH AVE NE SUITE 110
Bellevue, WA 98004
(425) 450-9801
0.2 mi
Lorinda Hagstrom, OTR
Occupational Therapist in Private Practice
NPI 1639325582
1417 116TH AVE NE STE 110
Bellevue, WA 98004
(425) 688-5900
✔ Accepts Medicare0.2 mi
Katherine Oberhofer, MS CCC-SLP
Qualified Speech Language Pathologist
NPI 1023082286
1417 116TH AVE NE STE 110
Bellevue, WA 98004
(425) 688-5911
✔ Accepts Medicare0.2 mi
Jennifer Richards, MD
Family Practice
NPI 1033227814
1200 112TH AVE NE #B250
Bellevue, WA 98004
(206) 386-9500
✔ PECOS✔ Accepts Medicare0.2 mi
Samantha Condiotty, ARNP
Nurse Practitioner
NPI 1184896367
11522 NE 20TH ST
Bellevue, WA 98004
(425) 462-2531
✔ PECOS✔ Accepts Medicare0.3 mi
Renu Chawla, MD
Internal Medicine
NPI 1285634790
1407 116TH AVE NE SUITE 200
Bellevue, WA 98004
(425) 990-5222
✔ PECOS✔ Accepts Medicare0.3 mi
Wou Sang Han, M.D
Psychiatry
NPI 1548677719
2105 112TH AVE NE STE 200
Bellevue, WA 98004
(425) 598-6653
✔ PECOS✔ Accepts Medicare0.3 mi
Gretchen Crittenden, MD
Interventional Cardiology
NPI 1174559306
1414 116TH AVE NE SUITE E
Bellevue, WA 98004
(425) 455-9555
✔ PECOS✔ Accepts Medicare0.3 mi
John Holder, MD
Cardiovascular Disease (Cardiology)
NPI 1518994003
1414 116TH AVE NE SUITE E
Bellevue, WA 98004
(425) 455-9555
✔ PECOS0.3 mi
Sung Cho, MD
General Surgery
NPI 1588822951
1231 116TH AVE NE SUITE 535
Bellevue, WA 98004
(425) 688-1916
✔ PECOS✔ Accepts Medicare0.3 mi
See all 562 clinicians

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 Compliance 50D1030619

Overlake Medical Clinics Issaquah Urgent Care · Issaquah, WA
Active · expires Apr 4, 2028
CLIA Number50D1030619
Laboratory TypeClinic
Certificate Effective DateJanuary 11, 2012
Certificate Expiration DateApril 4, 2028
Laboratory DirectorNafiseh L. Haghgoo
Laboratory Phone(425) 688-5777
Laboratory LocationOverlake Medical Clinics Issaquah Urgent Care5708 E Lake Sammamish Pkwy SE, Issaquah, WA 98029
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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 Overlake Medical Clinics LLC's NPI number?

The NPI number for Overlake Medical Clinics LLC is 1871745703. It was assigned to this organization in the NPPES registry on October 22, 2008.

Where is Overlake Medical Clinics LLC located?

Overlake Medical Clinics LLC is located at 1750 112th Ave NE Suite A101, Bellevue, WA 98004. The listed phone number is (425) 688-5234.

What is Overlake Medical Clinics LLC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Is Overlake Medical Clinics LLC enrolled in Medicare?

Yes. Overlake Medical Clinics LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Overlake Medical Clinics LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 562 clinicians in 46 Medicare specialties reassign their Medicare billing to Overlake Medical Clinics 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. The largest specialties are Nurse Practitioner (98), Family Practice (89) and Internal Medicine (63). Of these, 9 practice at this address and 386 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Overlake Medical Clinics LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 50D1030619) 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 Overlake Medical Clinics LLC accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Overlake Medical Clinics LLC 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 Overlake Medical Clinics LLC was last updated on October 22, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.