Individual provider Active NPI

Anirban Das, D.O.

  • Family Medicine Physician
  • Mount Vernon, WA
National Provider Identifier
1083889190
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP00002234 Issued in WA
Practice address
1400 E Kincaid St
Mount Vernon, WA 98274-4127
Phone
(360) 428-6434
Fax
(360) 848-4233
NPI assigned
Apr 29, 2008
Last updated
Nov 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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 OP00002234 WA Primary

Addresses

Primary practice location

1400 E Kincaid St
Mount Vernon, WA 98274-4127

Mailing address

4300 Blackstone Way
Bellingham, WA 98226-7779

Other practice location 1

201 16th Ave E
Seattle, WA 98112-5226
Phone (206) 326-3000

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address adas15643@skagit.direct-ci.com Direct
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE)

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
I20080729000708 WA Practitioner - Family PracticePractitioner - Other (Physician) 5890869515 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Overlake Medical Clinics LLCGroup PAC ID 7012808827, 423 clinicians

Practice addresses (Care Compare)

17209 Redmond Way
Redmond, WA 98052-4404
Phone (425) 635-6400

1750 112TH Ave NE
Suite B102
Bellevue, WA 98004-3772
Phone (425) 688-5460

5708 E Lake Samm Pkwy SE
Issaquah, WA 98029-8942
Phone (425) 688-5488

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21451CAMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Public Hospital Dist No 1 Skagit Current Accepting new patients
Public Hospital Dist No 1 Skagit CurrentSince Nov 29, 2015 Accepting new patients
Optum Care Washington PLLC Family Medicine CurrentSince Aug 1, 2008 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Nov 13, 2023 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Nov 13, 2023 Accepting new patients
Overlake Medical Clinics, LLC Current Accepting new patients
Public Hospital Dist No 1 Skagit CurrentSince Nov 29, 2015 Accepting new patients
Optum Care Washington PLLC Family Medicine CurrentSince Aug 1, 2008 Accepting new patients
Overlake Medical Clinics LLC CurrentSince Apr 7, 2018 Accepting new patients
Bourget Health Services Inc Past Accepting new patients
Issaquah Obstetrics and Gynecology PLLC Past Accepting new patients
Public Hospital District 1 of King County Past Accepting new patients
Radia Inc P S Past Accepting new patients

Locations

1750 112th Ave NE
Ste B102
Bellevue, WA 98004
Phone (425) 688-5460

619 156th Ave SE
Bellevue, WA 98007
Phone (425) 637-3270

11913 NE 195th St
Bothell, WA 98011
Phone (425) 489-3100

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

5708 E Lake Sammamish Pkwy SE
Ste 102
Issaquah, WA 98029
Phone (425) 688-5488

6520 226th Pl SE
Ste 150
Issaquah, WA 98027
Phone (425) 688-5777

1400 E Kincaid St
Mount Vernon, WA 98274
Phone (360) 428-2586

17209 Redmond Way
Redmond, WA 98052
Phone (425) 635-6400

200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530

201 16th Ave E
Seattle, WA 98112
Phone (206) 326-4545

9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800

Interoperability endpoints

  • Direct secure messaging: adas15643@skagit.direct-ci.com

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 2

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": "1209427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1083889190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 BLACKSTONE WAY",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982267779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 E KINCAID ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744127",
            "telephone_number": "360-428-6434",
            "fax_number": "360-848-4233"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 16th Ave E",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981125226",
            "country_code": "US",
            "telephone_number": "206-326-3000",
            "fax_number": "877-515-2975",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAS",
        "first_name": "ANIRBAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-29",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP00002234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adas15643@skagit.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "Provider Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1400 E Kincaid St",
            "city": "Mount Vernon",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982744127",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "201 16th Ave E",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981125226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

Verify at the official NPI Registry.