NPIMap

Individual provider Active NPI

Mumin Daud Dimbil, MD

  • Family Medicine Physician
  • Des Moines, WA
National Provider Identifier
1073645230
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00047922 Issued in WA
Practice address
22000 Marine View Dr S Ste 100
Des Moines, WA 98198-6233
Phone
(206) 870-4460
Fax
(206) 870-4770
NPI assigned
Mar 12, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00047922 WA Primary

Addresses

Primary practice location

22000 Marine View Dr S Ste 100
Des Moines, WA 98198-6233

Mailing address

22000 Marine View Dr S Ste 100
Des Moines, WA 98198-6233
Phone (206) 870-4460

Other identifiers 1

IdentifierTypeStateIssuer
1042758MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mdimbil61829@fhsce.catholichealth.net Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070629000138 WA Practitioner - Family Practice 9537268727 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians

Practice addresses (Care Compare)

22000 Marine View Dr S
Suite 100
Des Moines, WA 98198-6233
Phone (206) 870-4460

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD00047922WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Family Medicine CurrentSince Oct 26, 2013 Accepting new patients
Franciscan Medical Group Current Accepting new patients
Seahurst Pediatrics PLLC Past Accepting new patients
Franciscan Medical Group Family Medicine Past Accepting new patients

Locations

21 NE Romance Hill Rd
Ste 105
Belfair, WA 98528
Phone (360) 277-2950

16045 1st Ave S
Fl 1
Burien, WA 98148
Phone (206) 965-4100

22000 Marine View Dr S
Ste 100
Des Moines, WA 98198
Phone (206) 592-5960

34503 9th Ave S
Ste 130
Federal Way, WA 98003
Phone (253) 835-5340

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Interoperability endpoints

  • Direct secure messaging: mdimbil61829@fhsce.catholichealth.net

Organizations & group practices 4

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 8

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": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1073645230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22000 MARINE VIEW DR S STE 100",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981986233",
            "telephone_number": "206-870-4460",
            "fax_number": "206-870-4770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22000 MARINE VIEW DR S STE 100",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981986233",
            "telephone_number": "206-870-4460",
            "fax_number": "206-870-4770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMBIL",
        "first_name": "MUMIN",
        "middle_name": "DAUD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00047922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1042758",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mdimbil61829@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "22000 Marine View Dr S Ste 100",
            "city": "Des Moines",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981986233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Des Moines, WA

Sources for this page

Verify at the official NPI Registry.