ICHS Bellevue Medical and Dental Clinic – Federally Qualified Health Center (FQHC), NPI 1114363157

ICHS Bellevue Medical and Dental Clinic is a healthcare provider. based in Seattle, Washington. specializing in Federally Qualified Health Center (FQHC). The organization holds a License No. 600436519 (WA). The NPI Number for ICHS Bellevue Medical and Dental Clinic is 1114363157

Main info

Organization
Name
ICHS Bellevue Medical and Dental Clinic
NPI
1114363157
Phone
(206) 788-3700
Address
PO BOX 3007
Authorized Official
HERMES SHAHBAZIAN CFO
Enumeration Date
17 May 2013
Last Update Date
29 March 2021
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness80
Years active:13State licenses:1Digital endpointsUpdated within 12 months

Provider Addresses for ICHS Bellevue Medical and Dental Clinic

  • PO BOX 3007

    SEATTLE, WA 981143007

    Phone: (206) 788-3700

    Fax: (206) 788-3521

    Type: Mailing

  • 1050 140TH AVE NE

    BELLEVUE, WA 980052972

    Phone: (425) 373-3000

    Fax: (425) 373-3100

    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.

This can happen when there are no reportable CMS Open Payments records.

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: 2014-07-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2025-07-31 (314 days ago).

Enrollment records

2

Earliest due date

2025-07-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20040301000204OClinic/Group PracticeWATBD
O20140729000114OFederally Qualified Health Center (Fqhc)WA2025-07-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98114)

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Reviews

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Frequently asked questions

Is there an official ID for ICHS Bellevue Medical and Dental Clinic in U.S. healthcare records?
The official identifier for ICHS Bellevue Medical and Dental Clinic is NPI 1114363157.
Is there an active status for ICHS Bellevue Medical and Dental Clinic?
For scheduling context, ICHS Bellevue Medical and Dental Clinic is shown as active in the registry.
What area of care is associated with ICHS Bellevue Medical and Dental Clinic?
ICHS Bellevue Medical and Dental Clinic's record emphasizes Federally Qualified Health Center (FQHC). Clinical services aligned with this taxonomy classification.
Is ICHS Bellevue Medical and Dental Clinic located near Seattle?
ICHS Bellevue Medical and Dental Clinic currently maps to Seattle, Washington in this extract.
Can I trust this NPI listing for ICHS Bellevue Medical and Dental Clinic?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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