Individual provider Active NPI

Abbas Navroze Asgerally, M.D.

  • Pain Medicine Physician
  • Vancouver, WA
National Provider Identifier
1104269711
Registry record updated Dec 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine PhysicianTaxonomy code 208VP0000X
License
MD60835773 Issued in WA
Practice address
2312 NE 129TH St
Vancouver, WA 98686-3236
Phone
(360) 546-8950
Fax
(360) 696-5445
NPI assigned
Apr 12, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 60835773 WA
Pain Medicine (Anesthesiology) Physician 207LP2900X 60835773 WA
Student in an Organized Health Care Education/Training Program 390200000X
Pain Medicine Physician 208VP0000X MD60835773 WA Primary

Addresses

Primary practice location

2312 NE 129TH St
Vancouver, WA 98686-3236

Mailing address

PO Box 1600
Vancouver, WA 98668-1600
Phone (360) 696-5022

Other practice location 1

2312 NE 129th St
Vancouver, WA 98686-3236
Phone (360) 696-5022

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
I20180723002879 WA Practitioner - Pain ManagementPractitioner - Anesthesiology 9830446863 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pain ManagementAlso: Anesthesiology
Education
Rutgers, Robert Woood Johnson Medical School, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
PeacehealthGroup PAC ID 9739092065, 101 clinicians

Practice addresses (Care Compare)

2312 NE 129TH St
Vancouver, WA 98686-3236
Phone (360) 546-8000

400 NE Mother Joseph PL
Vancouver, WA 98664-3200
Phone (360) 514-1734

Hospital & facility affiliations

  • Peacehealth Southwest Medical Cente Hospital, Vancouver, WA, CCN 500050

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60835773WAMDAnesthesiology Physician
MD60835773WAMDPain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Anesthesia Group P S Anesthesiology CurrentSince Oct 15, 2018 Accepting new patients
Peacehealth CurrentSince Jan 18, 2021 Accepting new patients
Peacehealth CurrentSince Jan 18, 2021 Accepting new patients

Locations

400 NE Mother Joseph Pl
Vancouver, WA 98664
Phone (360) 514-2000

2312 NE 129th St
Vancouver, WA 98686
Phone (360) 546-8950

1115 SE 164th Ave
Dept 358
Vancouver, WA 98683
Phone (360) 729-1253

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.

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": "1365724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1104269711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1600",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986681600",
            "telephone_number": "360-696-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2312 NE 129TH ST",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986863236",
            "telephone_number": "360-546-8950",
            "fax_number": "360-696-5445"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2312 NE 129th St",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986863236",
            "country_code": "US",
            "telephone_number": "360-696-5022",
            "fax_number": "360-696-5445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ASGERALLY",
        "first_name": "ABBAS",
        "middle_name": "NAVROZE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-12",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "60835773",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "WA",
            "license": "60835773",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "WA",
            "license": "MD60835773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

Verify at the official NPI Registry.