Proliance Eastside Surgery Center – Ambulatory Surgical Clinic/Center, NPI 1790724862
Ambulatory Surgical Clinic/Center
Main info
Profile Insights
NPPES metrics only — not quality of care.
Loading map...
Provider Addresses for Proliance Eastside Surgery Center
12911 120TH AVE NE STE G10
KIRKLAND, WA 980343048
Phone:
Type: Mailing
Metropolitan Deli & Cafe, 805, Madison Street, Central Business District, First Hill, Seattle, King County, Washington, 98104, United States
SUITE 901
SEATTLE, WA 981041172
Phone: (206) 264-8100
Type: Mailing
12911, 120th Avenue Northeast, Kirkland, King County, Washington, 98034, United States
SUITE H-110
KIRKLAND, WA 980343027
Phone: (425) 216-7000
Fax: (425) 216-7019
Type: Location
12911 120TH AVE NE STE H110
KIRKLAND, WA 980343061
Phone: (425) 216-7000
Fax: (425) 216-7019
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
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: 2003-12-08
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 |
|---|---|---|---|---|
| O20031208000102 | O | Ambulatory Surgical Center | 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 |
|---|---|---|---|---|
| C9290 | Injection, bupivacaine liposome, 1 mg | 20,971 | 102 | $0 |
| 26145 | Repair of tendon, finger, and/or palm of hand | 119 | 90 | $0 |
| 29848 | Release of wrist ligament using an endoscope | 74 | 62 | $0 |
| 27447 | Replacement of knee joint, both sides of knee | 53 | 52 | $0 |
| 29827 | Repair of shoulder rotator cuff using an endoscope | 39 | 39 | $0 |
Insurance plans in this area (ZIP 98034)
Loading plans...
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.