Ali Sanei Moghaddam, MD, ABFM, CCFP, MRCS

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD61075057 Issued in WA

Practice address

5416 Snow Goose LN Unit 405
Blaine, WA 98230-6316

Phone

(425) 515-9022

Fax

(604) 200-5047

NPI assigned

Mar 16, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA, OR2 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ali.sanei.moghaddam.1@30646.direct.athenahealth.com
• Direct secure messaging: ms_asaneim@landmarkhealth-direct.org

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.

• Peacehealth Networks on Demand, LLC

  • General Practice Physician
  • Tigard, OR
  • NPI 1023582178

  Single Specialty, WA

  Medicare reassignment NPD
• Zoomcare Urgent Care LLC

  • Urgent Care Clinic/Center
  • Lake Oswego, OR
  • NPI 1376225813

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1615852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1114502564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5416 SNOW GOOSE LN UNIT 405",
            "city": "BLAINE",
            "state": "WA",
            "postal_code": "982306316",
            "telephone_number": "425-515-9022",
            "fax_number": "604-200-5047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5416 SNOW GOOSE LN UNIT 405",
            "city": "BLAINE",
            "state": "WA",
            "postal_code": "982306316",
            "telephone_number": "425-515-9022",
            "fax_number": "604-200-5047"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1050 SW 6th Ave Ste 1100",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972041153",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "195 Page Mill Rd Ste 103",
            "address_purpose": "LOCATION",
            "city": "Palo Alto",
            "state": "CA",
            "postal_code": "943062073",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "450 Alaskan Way S Ste 200",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981042785",
            "country_code": "US",
            "telephone_number": "888-731-8994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANEI MOGHADDAM",
        "first_name": "ALI",
        "name_prefix": "Dr.",
        "credential": "MD, ABFM, CCFP, MRCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-16",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD61075057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannan Francyne Ritter Von Trautmann, OTR
• James Joseph Roche, PHD
• Patrick James Rooney, D.D.S.
• Suzanne Ross
• Gagandeep Sandhu, DDS
• Elizabeth M Schnippel, ND
• Carolynn M. Slocum, B.S., ICCE
• Sandra Yvette Smith
• Sharon May Somers-Hill, RN
• Susan Soule

• Family Medicine Physician in Blaine, WA
• Providers in Blaine, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.