DR. DANIELLE KATHRYN IVANOVA (D.O.) – Behavioral Neurology & Neuropsychiatry Physician, NPI 1124462387
Behavioral Neurology & Neuropsychiatry Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. DANIELLE KATHRYN IVANOVA (D.O.)
1750 112TH AVE NE
STE B-102
BELLEVUE, WA 98004
Phone: (425) 688-5460
Fax: (425) 735-4667
Type: Location
MS 315010
PO BOX 3547
SEATTLE, WA 98124
Phone: (425) 467-3655
Fax: (248) 849-5378
Type: Mailing
1229 MADISON ST STE 500
SEATTLE, WA 981041305
Phone: (425) 326-5338
Fax: (425) 326-5338
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-07-10
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190710001447 | I | Psychiatry | WA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 53 | 27 | $0 |
| 90792 | Psychiatric diagnostic evaluation with medical services | 17 | 17 | $0 |
Insurance plans in this area (ZIP 98004)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| N E U R O L O G Y | CA | |
| Qualified Speech Language Pathologist | WA | |
| Physical Therapist In Private Practice | WA | |
| Family Practice | WA | |
| - | WA | |
| Physical Therapist In Private Practice | WA | |
| Family Practice | WA | |
| - | WA | |
| Nurse Practitioner | TX | |
| - | WA |
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