Individual provider Active NPI

Reeshma S Mohammed, MSN, FNP-BC

  • Gerontology Nurse Practitioner
  • Prosser, WA
National Provider Identifier
1063758100
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
AP70040793 Issued in WA
Practice address
355 Chardonnay Ave
Prosser, WA 99350-9521
Phone
(509) 781-6366
Fax
(509) 781-6367
NPI assigned
Dec 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 201603125NP-PP OR
Nurse Practitioner 363L00000X NP-13808 OH
Family Nurse Practitioner 363LF0000X AP125593 TX
Gerontology Nurse Practitioner 363LG0600X 201603125NP-PP OR
Gerontology Nurse Practitioner 363LG0600X AP70040793 WA Primary

Addresses

Primary practice location

355 Chardonnay Ave
Prosser, WA 99350-9521

Mailing address

PO Box 719
Sunnyside, WA 98944-0719
Phone (509) 837-1617

Other practice location 1

1000 McKinley Park Dr
Marion, OH 43302-6399
Phone (740) 383-7830

Other practice location 2

3181 SW Sam Jackson Park Rd # L586
Division of Hematology & Medical Oncology
Portland, OR 97239
Phone (503) 494-8534

Other practice location 3

5050 NE Hoyt St Ste 610
Portland, OR 97213-2985
Phone (503) 467-4761

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130502000302 OH Practitioner - Nurse Practitioner 6103063532 Reassigns benefits to 1 organization
I20251104004645 WA Practitioner - Nurse Practitioner 6103063532 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Martha'S Vineyard Hospital IncGroup PAC ID 9931166113, shared by 5 NPIs, 150 clinicians
Sunnyside Community Hospital AssociationGroup PAC ID 1658280896, 57 clinicians

Practice addresses (Care Compare)

1 Hospital Rd
Oak Bluffs, MA 02557-1406
Phone 508693041079525

355 Chardonnay Ave
Prosser, WA 99350-9521
Phone (509) 781-6366

Hospital & facility affiliations

  • Trios Health Hospital, Kennewick, WA, CCN 500053
  • Astria Sunnyside Hospital Hospital, Sunnyside, WA, CCN 501330
  • Kadlec Regional Medical Center Hospital, Richland, WA, CCN 500058
  • Providence St Vincent Medical Center Hospital, Portland, OR, CCN 380004

Merit-based Incentive Payment System (MIPS)

Final score
85.5 of 100Reported as apm
Quality
71.52
Promoting interoperability
95.57
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
78.42 of 100Reported as group
Quality
62.19
Promoting interoperability
99
Improvement activities
40
Cost
61.29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP-13808OHMDNurse Practitioner
AP125593TXMDFamily Nurse Practitioner
201603125NP-PPORMDGerontology Nurse Practitioner
AP70040793WAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sunnyside Community Hospital Association CurrentSince Oct 1, 2025 Accepting new patients
Sunnyside Community Hospital Association Family CurrentSince Oct 1, 2025 Accepting new patients
Sunnyside Community Hospital Association Current Accepting new patients
Marion Area Physicians LLC CurrentSince Jul 1, 2024 Accepting new patients
Sunnyside Community Hospital Association CurrentSince Oct 1, 2025 Accepting new patients

Locations

Dept L3652
Columbus, OH 43260

1000 McKinley Park Dr
Marion, OH 43302
Phone (740) 383-8400

1040 Delaware Ave
Marion, OH 43302
Phone (330) 256-9874

355 Chardonnay Ave
Prosser, WA 99350
Phone (509) 781-6366

1016 Tacoma Ave
Sunnyside, WA 98944
Phone (509) 823-6682

2925 Allen Rd
Sunnyside, WA 98944
Phone (509) 837-4949

Interoperability endpoints

  • Direct secure messaging: rmohammed3850520@oc.providencedirect.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 and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1355788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1063758100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 719",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989440719",
            "telephone_number": "509-837-1617",
            "fax_number": "509-837-4908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 CHARDONNAY AVE",
            "city": "PROSSER",
            "state": "WA",
            "postal_code": "993509521",
            "telephone_number": "509-781-6366",
            "fax_number": "509-781-6367"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 McKinley Park Dr",
            "address_purpose": "LOCATION",
            "city": "Marion",
            "state": "OH",
            "postal_code": "433026399",
            "country_code": "US",
            "telephone_number": "740-383-7830",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3181 SW Sam Jackson Park Rd # L586",
            "address_2": "Division of Hematology & Medical Oncology",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "97239",
            "country_code": "US",
            "telephone_number": "503-494-8534",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5050 NE Hoyt St Ste 610",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972132985",
            "country_code": "US",
            "telephone_number": "503-467-4761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOHAMMED",
        "first_name": "REESHMA",
        "middle_name": "S",
        "credential": "MSN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-18",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "201603125NP-PP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "NP-13808",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP125593",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OR",
            "license": "201603125NP-PP",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "WA",
            "license": "AP70040793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prosser, WA

Sources for this page

Verify at the official NPI Registry.