Individual provider Active NPI

Rami Soufan, DO

  • Anesthesiology Physician
  • Bremerton, WA
National Provider Identifier
1104320597
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
OP61420516 Issued in WA
Practice address
990 Sylvan Way Ste 101
Bremerton, WA 98310-2851
Phone
(360) 479-3657
NPI assigned
Mar 20, 2018
Last updated
Jul 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Anesthesiology Physician 207L00000X 125075187 IL
Anesthesiology Physician 207L00000X OP61420516 WA Primary
Critical Care Medicine (Anesthesiology) Physician 207LC0200X OP61420516 WA
Critical Care Medicine (Anesthesiology) Physician 207LC0200X OS022068 PA

Addresses

Primary practice location

990 Sylvan Way Ste 101
Bremerton, WA 98310-2851

Mailing address

990 Sylvan Way Ste 101
Bremerton, WA 98310-2851

Other practice location 1

400 N Pepper Ave
Colton, CA 92324-1801
Phone (909) 580-3362

Other practice location 2

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-9000

Other practice location 3

3400 Spruce St Ste 680
Philadelphia, PA 19104-4238
Phone (800) 789-7366

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230324000455 PA Practitioner - Anesthesiology 5294062758 Reassigns benefits to 1 organization
I20230803003289 WA Practitioner - Anesthesiology 5294062758 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Midwestern University, Chicago College of Osteopathic Med, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franciscan Medical GroupGroup PAC ID 0547173866, 1,400 clinicians
Olympic Anesthesia Services, IncGroup PAC ID 4587551064, 38 clinicians

Practice addresses (Care Compare)

1800 NW Myhre Rd
Silverdale, WA 98383-7663
Phone (564) 240-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OP61420516WAMDCritical Care Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group Anesthesiology CurrentSince Dec 1, 2023 Accepting new patients
University of Penn-Medical Group Current Accepting new patients
Olympic Anesthesia Services, Inc Anesthesiology CurrentSince Aug 1, 2023 Accepting new patients
Franciscan Medical Group CurrentSince Dec 1, 2023 Accepting new patients
Loyola University Medical Center Current Accepting new patients
University of Penn-Medical Group CurrentSince Jan 1, 2023 Accepting new patients
University of Penn-Medical Group CurrentSince Jan 1, 2023 Accepting new patients

Locations

2160 S 1st Ave
Maywood, IL 60153
Phone (708) 216-4400

3737 Market St
#5
Philadelphia, PA 19104
Phone (215) 662-2739

2520 Cherry Ave
Bremerton, WA 98310
Phone (360) 377-3911

990 Sylvan Way
Bremerton, WA 98310
Phone (360) 479-3654

990 Sylvan Way
Ste 101
Bremerton, WA 98310
Phone (360) 479-3657

34503 9th Ave S
Ste 130
Federal Way, WA 98003
Phone (253) 835-5340

20669 Bond Rd NE
Ste 200
Poulsbo, WA 98370
Phone (360) 779-6527

1800 NW Myhre Rd
Silverdale, WA 98383
Phone (360) 337-8800

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Interoperability endpoints

  • Direct secure messaging: rsoufan102064@direct.luhs.org

Organizations & group practices 8

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.

Hospital & facility affiliations 1

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": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1104320597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 SYLVAN WAY STE 101",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983102851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 SYLVAN WAY STE 101",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983102851",
            "telephone_number": "360-479-3657"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 N Pepper Ave",
            "address_purpose": "LOCATION",
            "city": "Colton",
            "state": "CA",
            "postal_code": "923241801",
            "country_code": "US",
            "telephone_number": "909-580-3362",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2160 S 1st Ave",
            "address_purpose": "LOCATION",
            "city": "Maywood",
            "state": "IL",
            "postal_code": "60153",
            "country_code": "US",
            "telephone_number": "708-216-9000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3400 Spruce St Ste 680",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191044238",
            "country_code": "US",
            "telephone_number": "800-789-7366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOUFAN",
        "first_name": "RAMI",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-20",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "125075187",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "OP61420516",
            "primary": true
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "WA",
            "license": "OP61420516",
            "primary": false
        },
        {
            "code": "207LC0200X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Critical Care Medicine",
            "state": "PA",
            "license": "OS022068",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

Verify at the official NPI Registry.