Individual provider Active NPI

Amir Gharaei, M.D.

  • Pulmonary Disease Physician
  • Bellingham, WA
National Provider Identifier
1063638773
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
99102094A Issued in IN
Practice address
3015 Squalicum Pkwy
Suite 140
Bellingham, WA 98225-1945
Phone
(360) 788-6112
NPI assigned
Apr 18, 2007
Last updated
Jan 26, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT183118 PA
Internal Medicine Physician 207R00000X 40719 AZ
Pulmonary Disease Physician 207RP1001X MD60287303 WA
Pulmonary Disease Physician 207RP1001X 99102094A IN Primary
Hospitalist Physician 208M00000X 40719 AZ

Addresses

Primary practice location

3015 Squalicum Pkwy
Suite 140
Bellingham, WA 98225-1945

Mailing address

1115 SE 164TH Ave
Dept 364
Vancouver, WA 98683-9324
Phone (360) 788-6112

Other practice location 1

11104 Parkview Circle Dr Ste 410
Fort Wayne, IN 46845-0025
Phone (260) 266-7856

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, IN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130725000248 WA Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 1456409358 Reassigns benefits to 3 organizations
I20220204001881 IN Practitioner - Pulmonary Disease 1456409358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists), Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PeacehealthGroup PAC ID 9537073960, 292 clinicians

Practice addresses (Care Compare)

2901 Sqaulicum Pkwy
Bellingham, WA 98225-1851
Phone (360) 788-9373

2980 Squalicum Pkwy
Bellingham, WA 98225-1880
Phone (360) 788-6112

3015 Squalicum Pkwy
Bellingham, WA 98225-1906

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
40719AZMDInternal Medicine Physician
MT183118PAMDInternal Medicine Physician
99102094AINMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peacehealth Family Medicine CurrentSince Jul 1, 2013 Accepting new patients
Peacehealth Medical Group - Sedro Woolley Family Medicine CurrentSince Sep 23, 2018 Accepting new patients
Wenatchee Valley Hospital CurrentSince Apr 15, 2021 Accepting new patients
Parkview Health System Inc Family Medicine Current Accepting new patients
Parkview Health System, Inc. Family Medicine CurrentSince Dec 20, 2021 Accepting new patients
Flagstaff Medical Center Past Accepting new patients

Locations

11104 Parkview Circle Dr
Ste 410
Fort Wayne, IN 46845
Phone (260) 266-5260

11109 Parkview Plaza Dr
Fort Wayne, IN 46845
Phone (260) 266-2020

512 Professional Way
Kendallville, IN 46755
Phone (260) 347-8556

2901 Squalicum Pkwy
Bellingham, WA 98225
Phone (360) 734-5400

2980 Squalicum Pkwy
Ste 301
Bellingham, WA 98225
Phone (360) 671-4944

3015 Squalicum Pkwy
Ste 100
Bellingham, WA 98225
Phone (360) 715-4186

3015 Squalicum Pkwy
Ste 140
Bellingham, WA 98225
Phone (360) 738-9570

3015 Squalicum Pkwy
Ste 200
Bellingham, WA 98225
Phone (360) 733-2092

835 E Fairhaven Ave
Burlington, WA 98233
Phone (360) 755-0641

1990 Hospital Dr
Ste 100
Sedro Woolley, WA 98284
Phone (360) 856-8800

17 S Western Ave
Tonasket, WA 98855
Phone (509) 486-2174

1115 SE 164th Ave
Dept 364
Vancouver, WA 98683
Phone (360) 735-8100

1201 S Miller St
Wenatchee, WA 98801
Phone (509) 662-2208

820 N Chelan Ave
Wenatchee, WA 98801
Phone (509) 863-4868

933 Red Apple Rd
Wenatchee, WA 98801
Phone (509) 655-6125

Networks

  • WA PPO C-SNP
  • devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Interoperability endpoints

  • Direct secure messaging: agharaei16291@direct.peacehealth.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1063638773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 SE 164TH AVE",
            "address_2": "DEPT 364",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986839324",
            "telephone_number": "360-788-6112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 SQUALICUM PKWY",
            "address_2": "SUITE 140",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251945",
            "telephone_number": "360-788-6112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11104 Parkview Circle Dr Ste 410",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468450025",
            "country_code": "US",
            "telephone_number": "260-266-7856",
            "fax_number": "260-266-5279",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHARAEI",
        "first_name": "AMIR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT183118",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "40719",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "WA",
            "license": "MD60287303",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "IN",
            "license": "99102094A",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "AZ",
            "license": "40719",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

Verify at the official NPI Registry.