NORTH PACIFIC DERMATOLOGY PS
NPI 1881845907
Clinic/Center - Ambulatory Surgical in Renton, WA
About North Pacific Dermatology Ps NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NORTH PACIFIC DERMATOLOGY PS (NPI 1881845907) is a healthcare organization registered as an ambulatory surgical in Renton, Washington and active in the NPI registry since October 2008. The organization holds a CLIA Certificate of Compliance certificate valid through April 4, 2028, maintains a secondary practice location in Bellevue, and lists Nobuyoshi Kageyama, Secretary/treasurer, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 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)
North Pacific Dermatology Ps is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
22Medicare enrollment records show 22 clinicians reassign Medicare billing to North Pacific Dermatology Ps, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 3 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 2
Nearest to this location (20)
See all 22Source: 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 50D1085511
North Pacific Dermatology, Ps · Bellevue, WAAreas of Expertise CMS Part B claims 7
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
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 North Pacific Dermatology Ps's NPI number?
The NPI number for North Pacific Dermatology Ps is 1881845907. It was assigned to this organization in the NPPES registry on October 7, 2008.
Where is North Pacific Dermatology Ps located?
North Pacific Dermatology Ps is located at 1412 SW 43rd St Ste 205, Renton, WA 98057. The listed phone number is (425) 264-0660.
What is North Pacific Dermatology Ps's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.
Is North Pacific Dermatology Ps enrolled in Medicare?
Yes. North Pacific Dermatology Ps is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through North Pacific Dermatology Ps?
According to the CMS Revalidation Reassignment List (October 2026 release), 22 clinicians in 2 Medicare specialties reassign their Medicare billing to North Pacific Dermatology Ps. 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 Dermatology (20) and Nurse Practitioner (2). Of these, 2 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does North Pacific Dermatology Ps hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 50D1085511) 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 North Pacific Dermatology Ps accept?
Health plans from Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list North Pacific Dermatology Ps 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 North Pacific Dermatology Ps was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# North Pacific Dermatology Ps · NPI 1881845907
Ambulatory Surgical organization in Renton, Washington. Organization record, active in the CMS NPPES registry since October 7, 2008.
## Identity
- **NPI:** 1881845907 (Entity type: Organization)
- **Enumerated:** October 7, 2008
- **Primary specialty:** Clinic/Center - Ambulatory Surgical · taxonomy 261QA1903X
- **Organization subpart:** No
- **Authorized official:** Nobuyoshi Kageyama, SECRETARY/TREASURER
## Practice location
- **Address:** 1412 SW 43RD ST, STE 205, Renton, WA 98057-4803
- **Phone:** (425) 264-0660 · **Fax:** (425) 264-0601
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 22 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Dermatology (20), Nurse Practitioner (2); 2 practice at this address and 3 within 10 miles; [full list](https://npiprofile.com/npi/1881845907/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 21, 2022
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1881845907) · Data from the CMS NPPES public registry.