NPIMap

Organization Active NPI

Mahnaz Lary MD Inc PS

  • Internal Medicine Physician
  • Bellingham, WA
National Provider Identifier
1083960751
Registry record updated Nov 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MAHNAZ LARY MD INC PS
Practice address
2950 Squalicum Pkwy
Bellingham, WA 98225-1857
Phone
(360) 671-7100
NPI assigned
Jul 31, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2012

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

Authorized official

Name
Mahnaz Lary, MDNPI 1285732289
Title
Owner, MD
Phone
(618) 942-3777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2950 Squalicum Pkwy
Bellingham, WA 98225-1857

Mailing address

2950 Squalicum Pkwy
Bellingham, WA 98225-1857
Phone (360) 671-7100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121113000024 WA Part B Supplier - Clinic/Group Practice 1355592759 Receives reassigned benefits from 5 practitioners
Practice locations: Bellingham, WA

National Provider Directory

National Provider Directory

Locations

1050 Lakeway Dr
Ste B
Bellingham, WA 98229

1050 Lakeway Dr
Bellingham, WA 98229
Phone (360) 671-7100

1211 Cornwall Ave
Bellingham, WA 98225
Phone (360) 671-1700

2950 Squalicum Pkwy
Bellingham, WA 98225
Phone (360) 671-7100

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1343692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352246400000",
    "number": "1083960751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 SQUALICUM PKWY",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251857",
            "telephone_number": "360-671-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 SQUALICUM PKWY",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251857",
            "telephone_number": "360-671-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAHNAZ LARY MD INC PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-31",
        "last_updated": "2012-11-07",
        "status": "A",
        "authorized_official_last_name": "LARY",
        "authorized_official_first_name": "MAHNAZ",
        "authorized_official_title_or_position": "OWNER, MD",
        "authorized_official_telephone_number": "618-942-3777",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.