Vida Intagrated Health – Sports Physician Chiropractor, NPI 1790261444
Sports Physician Chiropractor
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Vida Intagrated Health
11901 NE VILLAGE PLAZA, SUITE 261
KIRKLAND, WA 980345092
Phone: (425) 814-2800
Fax: (425) 823-0882
Type: Location
121st Way Northeast, Kirkland, King County, Washington, 98034-7114, United States
KIRKLAND, WA 980343008
Phone: (425) 814-2800
Fax: (425) 823-0882
Type: Location
15, Southwest Everett Mall Way, Everett, Snohomish County, Washington, 98204, United States
EVERETT, WA 982042715
Phone: (425) 355-5222
Fax: (425) 355-5231
Type: Mailing
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.
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2023-09-30 (983 days ago).
Enrollment records
1
Earliest due date
2023-09-30
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 |
|---|---|---|---|---|
| O20110124000928 | O | Clinic/Group Practice | WA | 2023-09-30 |
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.
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 98034)
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