Individual provider Active NPI

Peter James Berberian, M.D.

  • Family Medicine Physician
  • Burien, WA
National Provider Identifier
1104187467
Registry record updated Apr 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ML60288820 Issued in WA
Practice address
14434 Ambaum Blvd SW Ste 5
Burien, WA 98166-1438
Phone
(206) 812-6140
Fax
(206) 812-2466
NPI assigned
Jun 4, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2025

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 ML60288820 WA Primary

Addresses

Primary practice location

14434 Ambaum Blvd SW Ste 5
Burien, WA 98166-1438

Mailing address

PO Box 34703
Seattle, WA 98124-1703

Other practice location 1

550 16th Ave Ste 100
Seattle, WA 98122-5636
Phone (206) 762-3730

Other identifiers 1

IdentifierTypeStateIssuer
2020685MedicaidWA

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
I20150716003174 WA Practitioner - Family Practice 4880907096 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, Geffen School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sea Mar Community Health CentersGroup PAC ID 7315831161, 235 clinicians

Practice addresses (Care Compare)

14434 Ambaum Blvd SW
Suite 5
Burien, WA 98166-1438
Phone (206) 812-6140

8720 14TH Ave S
Seattle, WA 98108-4807
Phone (206) 762-3730

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ML60288820WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sea Mar Community Health Centers CurrentSince Jun 19, 2018 Accepting new patients
Sea Mar Community Health Centers Family Medicine Current Accepting new patients
Sea Mar Community Health Centers Family Medicine CurrentSince Jun 19, 2018 Accepting new patients
Swedish Health Services Past Accepting new patients
Sea-Mar Community Health Center Family Medicine Past Accepting new patients

Locations

14434 Ambaum Blvd SW
Ste 5
Burien, WA 98166
Phone (206) 244-9482

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

8720 14th Ave S
Seattle, WA 98108
Phone (206) 762-3730

Interoperability endpoints

  • Direct secure messaging: pberberian450230@direct.multicare.org

Organizations & group practices 5

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": "1338768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743724800000",
    "number": "1104187467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34703",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981241703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14434 AMBAUM BLVD SW STE 5",
            "city": "BURIEN",
            "state": "WA",
            "postal_code": "981661438",
            "telephone_number": "206-812-6140",
            "fax_number": "206-812-2466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 16th Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981225636",
            "country_code": "US",
            "telephone_number": "206-762-3730",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERBERIAN",
        "first_name": "PETER",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-04",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "ML60288820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2020685",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burien, WA

Sources for this page

Verify at the official NPI Registry.