Individual provider Active NPI

Gary E Oppenheim, M.D.

  • Cardiovascular Disease Physician
  • Seattle, WA
National Provider Identifier
1083639249
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD00027825 Issued in WA
Practice address
550 17TH Ave
Suite 450
Seattle, WA 98122-5788
Phone
(206) 861-8550
Fax
(206) 861-8551
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD00027825 WA Primary

Addresses

Primary practice location

550 17TH Ave
Suite 450
Seattle, WA 98122-5788

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476

Other practice location 1

751 NE Blakely Dr Ste 3020
Issaquah, WA 98029-6201
Phone (425) 313-7123

Other practice location 2

515 Minor Ave
Seattle, WA 98104-2120
Phone (206) 320-6500

Other identifiers 2

IdentifierTypeStateIssuer
0194895OtherWAL & I
8119877MedicaidWA

Electronic endpoints 3

TypeEndpointUseAffiliation
Direct Messaging Address goppenheim1042773@wm.providencedirect.org Direct
Direct Messaging Address goppenheim1042773@wm.providencedirect.org Direct
Direct Messaging Address goppenheim1042773@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040426000018 WA Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Other (Physician) 0547256448 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.46 of 100Reported as group
Quality
80.66
Promoting interoperability
100
Improvement activities
40
Cost
77.55

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Seattle Heart and Vascular Center, LLC Cardiovascular Disease PastSince Jun 27, 2005 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1083639249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 17TH AVE",
            "address_2": "SUITE 450",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225788",
            "telephone_number": "206-861-8550",
            "fax_number": "206-861-8551"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "751 NE Blakely Dr Ste 3020",
            "address_purpose": "LOCATION",
            "city": "Issaquah",
            "state": "WA",
            "postal_code": "980296201",
            "country_code": "US",
            "telephone_number": "425-313-7123",
            "fax_number": "425-313-7177",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "515 Minor Ave",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981042120",
            "country_code": "US",
            "telephone_number": "206-320-6500",
            "fax_number": "206-320-6501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OPPENHEIM",
        "first_name": "GARY",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WA",
            "license": "MD00027825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L & I",
            "identifier": "0194895",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8119877",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "goppenheim1042773@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "515 Minor Ave",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981042120",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "goppenheim1042773@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "550 17th Ave",
            "address_2": "Suite 450",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981225788",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "goppenheim1042773@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "751 NE Blakely Dr Ste 3020",
            "city": "Issaquah",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980296201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.