Optum - Broadway – Audiologist, NPI 1174594634

Optum - Broadway is a healthcare provider. based in Seattle, Washington. specializing in Audiologist. The NPI Number for Optum - Broadway is 1174594634

Main info

Organization
Name
Optum - Broadway
NPI
1174594634
Phone
(206) 329-1760
Address
1145 BROADWAY
Authorized Official
CRAIG PEPIN PHYSICIAN/OWNER
Enumeration Date
31 January 2006
Last Update Date
13 May 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience65
Completeness80
Years active:20State licenses:0Digital endpointsUpdated within 12 months

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Provider Addresses for Optum - Broadway

  • 1145, Broadway, First Hill, Seattle, King County, Washington, 98138, United States

    SEATTLE, WA 981224201

    Phone: (206) 329-1760

    Mailing address matches the actual address.

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: 2010-09-30

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2024-02-29 (829 days ago).

Enrollment records

2

Earliest due date

2024-02-29

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
O20031210000788OClinic/Group PracticeWATBD
O20100930039601OMulti-Specialty - PhysicianWA2024-02-29

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 98122)

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Reviews

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Frequently asked questions

Is Optum - Broadway listed with a National Provider Identifier?
Yes — Optum - Broadway has NPI 1174594634 on file in the registry.
Would Optum - Broadway appear as active to a payer?
You can treat Optum - Broadway as active for directory purposes; confirm clinical privileges separately.
What expertise is attributed to Optum - Broadway?
Optum - Broadway's specialty line reads Audiologist. Clinical services aligned with this taxonomy classification.
Where in Washington is Optum - Broadway registered?
Use Seattle, Washington as the headline location for Optum - Broadway here.
When was this NPI issued?
Enumeration for Optum - Broadway is noted as January 31, 2006 where the registry provides it.

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