Individual provider Active NPI

Amarbir K Gill, M.D.

  • Family Medicine Physician
  • Kent, WA
National Provider Identifier
1093921496
Registry record updated Apr 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00047885 Issued in WA
Practice address
26004 104TH Ave SE Ste 101
Kent, WA 98030-7677
Phone
(425) 251-4040
NPI assigned
May 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MT183432 PA
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X MD00047885 WA Primary

Addresses

Primary practice location

26004 104TH Ave SE Ste 101
Kent, WA 98030-7677

Mailing address

26004 10TH Ave SE
Kent, WA 98030-7677
Phone (425) 251-4040

Other practice location 1

2 Sharpe St
Kingston, PA 18704-3715
Phone (570) 552-8900

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync 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
I20080206000483 WA Practitioner - Family Practice 8022191501 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

26004 104TH Ave SE
Suite 101
Kent, WA 98030-7677
Phone (425) 251-4050

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT183432PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kaiser Foundation Health Plan of Washington Single Specialty CurrentSince Aug 7, 2007 Accepting new patients
Kaiser Foundation Health Plan of Washington CurrentSince Aug 7, 2007 Accepting new patients
Kaiser Foundation Health Plan of Washington Single Specialty Current Accepting new patients

Locations

26004 104th Ave SE
Ste 101
Kent, WA 98030
Phone (425) 251-4040

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

209 Martin Luther King Jr Way
Tacoma, WA 98405
Phone (253) 596-3300

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

Interoperability endpoints

  • Direct secure messaging: agill20360@ghc.direct-ci.net

Organizations & group practices 3

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": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1093921496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26004 10TH AVE SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980307677",
            "telephone_number": "425-251-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26004 104TH AVE SE STE 101",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980307677",
            "telephone_number": "425-251-4040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Sharpe St",
            "address_purpose": "LOCATION",
            "city": "Kingston",
            "state": "PA",
            "postal_code": "187043715",
            "country_code": "US",
            "telephone_number": "570-552-8900",
            "fax_number": "570-552-8958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILL",
        "first_name": "AMARBIR",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MT183432",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00047885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwa.kp.org:14430/Interconnect-CE-PRD/wcf/epic.community.hie/xcpdrespondinggatewaysync",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "26004 104th Ave SE Ste 101",
            "city": "Kent",
            "state": "WA",
            "country_code": "US",
            "postal_code": "980307677",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Kent, WA

Sources for this page

Verify at the official NPI Registry.